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Diabetes Management
indeed help to obtain critical information to identify and define more
appropriate criteria for surgical indication, especially metrics of Federica del Genio, MD, PhD, is a Post-doctoral Research
diabetes (such as pancreatic insulin reserve or insulin resistance) and
Fellow in the Gastrointestinal Metabolic Surgery Division in
the Department of Surgery of Weill Cornell Medical
metabolic disease, in agreement with the modern concept of
College. Her research aims to elucidate the mechanisms
‘metabolic surgery.’ of diabetes control with gastrointestinal metabolic surgery
that could lead to a better understanding of diabetes and
Conclusions
obesity, and to evaluate the potential contribution of
surgery in the management of patients with diabetes.
Bariatric surgery and gastrointestinal surgical procedures in particular
have been shown to dramatically improve type 2 diabetes. This
Gladys Witt Strain, PhD, RD, is Director of Research for
evidence challenges long-held medical theories that consider diabetes
Laparoscopic and Bariatric Surgery and Associate
as a chronic, progressive, and irreversible illness. This surgery—also Research Professor of Nutritional Sciences in Surgery in
defined as metabolic surgery—used for diabetes treatment involves
the Department of Surgery at Weill Cornell Medical
College, where her research is focused on the resolution
a low risk of mortality in the immediate post-operative period and a
of diabetes after weight-loss surgery. She is nationally and
significant survival advantage over the long term compared with the internationally recognized for her research on the
mortality associated with the diagnosis of diabetes. BMI is actually
endocrinology of obesity, the problems of weight-loss
maintenance, and treatment of morbid obesity.
thought of as the most important parameter to evaluate obesity risk
and indications for gastrointestinal bypass procedures. In our opinion,
Francesco Rubino, MD, is Chief of Gastrointestinal Metabolic
it would be more accurate to consider various factors in patient
Surgery and Director of the Diabetes Surgery Center at Weill
Cornell Medical College/New York-Presbyterian Hospital. His
selection, including ethnicity, waist circumference, metrics of diabetes,
research showed for the first time that gastric bypass
and metabolic disease. Currently, we cannot argue that every patient
surgery can improve diabetes through direct antidiabetic
with diabetes is a candidate for gastrointestinal bypass procedures, but
mechanisms and not solely as a result of weight loss. His
clinical practice includes bariatric and metabolic surgery and
in the ‘appropriate’ patients surgery should be considered as an
his research interest focuses on gastrointestinal regulation
available treatment option, especially when diabetes is difficult to
of glucose homeostasis and appetite/satiety.
control by conventional medical therapies. n
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56 US ENDOCRINOLOGY
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