BMI cut-off for bariatric surgery ‘should be lower’ in diabetes

BARIATRIC surgery should be considered for patients with type 2 diabetes at a lower BMI than is currently recommended in Australia, according to the International Diabetes Federation (IDF).

In a position statement released last week, the IDF recommended surgery in patients with a BMI between 30 and 35 when diabetes was uncontrolled, especially if the patient has major cardiovascular risk factors.

NHMRC guidelines, currently under review, state surgery is indicated for patients with serious medical comorbidities and a BMI above 35.

Professor Paul Zimmet, international research director at the Baker IDI Heart and Diabetes Institute, Melbourne, and IDF report committee co-chair, said there was not a large evidence base for bariatric surgery at under-35 BMI, but it should be an option.

“We want to see in the management plans for type 2 diabetes in obese subjects, where routine therapies have failed, that people at least consider