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Comment & Response |

Bariatric Surgery for Patients With Type 2 Diabetes

Azeem Majeed, MD, FRCP, FRCGP, FFPH1
[+] Author Affiliations
1Department of Primary Care and Public Health, Imperial College London, London, England
JAMA Surg. 2016;151(4):396. doi:10.1001/jamasurg.2015.4641.
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To the Editor The results of the trial by Hsu and colleagues1 illustrate the importance of prioritizing obese people with type 2 diabetes mellitus when it comes to selecting patients for bariatric surgery. For example, the number of people eligible for bariatric surgery in England far exceeds the bariatric surgery capacity of its National Health Service.2 If the aim of bariatric surgery is to reduce mortality and morbidity among obese patients, then the focus should be on selecting patients for surgery based on the presence of the conditions that have the greatest detrimental effect on health status. It may therefore be appropriate to reconsider the importance of body mass index alone as a predictor of mortality and put more emphasis on the presence of comorbidities when assessing eligibility for bariatric surgery.3 Given the significant benefits for people with type 2 diabetes that bariatric surgery offers and the resulting major improvements in their health status, there is a strong case that type 2 diabetes should be considered as the preferred comorbidity when selecting patients for surgery.

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April 1, 2016
Chih-Cheng Hsu, MD; Wei-Jei Lee, MD
1Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan2Department of Health Services Administration, China Medical University, Taichung, Taiwan3Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan
3Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan
JAMA Surg. 2016;151(4):396. doi:10.1001/jamasurg.2015.4657.
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