Diabetes Surgery and New Interventional Treatments Offer New Hope to Patients With Type 2 Diabetes
NEW YORK (August 4, 2008) — The 1st World Congress on Interventional Therapies for Type 2 Diabetes will bring together leading experts in diabetes, endocrinology, surgery and public health to discuss the role of surgery and novel interventional therapies in the treatment of type 2 diabetes. The World Congress has been formed to address this emerging approach to diabetes and its implications for health care systems and patient care.
Led by Congress Director Dr. Francesco Rubino, surgeon-scientist at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, the Congress includes a faculty of more than 80 international leaders in endocrinology, surgery, and basic sciences, as well as public health specialists, insurers and top health authorities from the United States and worldwide. Dr. Rubino cited his reasons behind organizing the Congress this year, saying, "The epidemic growth of type 2 diabetes has created a race against time to find new approaches to treat and understand the disease. Diabetes surgery and other novel interventional techniques are not only a promising therapeutic option for selected patients with type 2 diabetes but also an unprecedented opportunity to shed light on the origin of the disease. To ensure a timely, scientific and safe development of this emerging discipline it is necessary to balance enthusiasm with caution. This is possible only with the immediate attention and responsible, urgent actions from the global diabetes community."
A growing body of evidence shows that bariatric surgery can improve type 2 diabetes, often resulting in normalization of blood glucose levels, discontinuation of diabetes-related medications, and reduction of diabetes-specific mortality. Experimental studies show that surgical control of type 2 diabetes is not only a secondary effect of weight loss, but also occurs as a consequence of the re-arrangement of gastrointestinal anatomy and the resulting hormonal changes. Not surprisingly, the interest for diabetes surgery is growing both in the scientific community and among the public at large.
As with any medical innovation, however, there are both opportunities and challenges. Although animal studies and early reports from clinical trials suggest that mildly obese or overweight patients with diabetes might benefit from diabetes surgery, long-term data in these patients are still limited and more studies are necessary to identify the ideal candidates. In spite of the limited evidence, diabetes surgery is already being utilized throughout the world, even in non-obese patients. "Implementation of widely accepted, international recommendations to avoid an inappropriate use of surgery and ensure respect of safety standards has become top priority," says Dr Rubino.
Despite the increasing evidence that bariatric surgery achieves long-term control of type 2 diabetes in patients who are severely obese (BMI over 35), only a few of these patients actually have access to this type of treatment. "While these procedures may be life-saving, less than 2 percent of those patients already eligible under current NIH recommendations are offered a surgical option in the U.S.," says Dr. Philip Schauer, past president of the American Society for Metabolic and Bariatric Surgery, Congress faculty member and surgeon at Cleveland Clinic. "This may be because of limited awareness among primary care physicians, surgeons and diabetes specialists, and insufficient insurance coverage."
Last year an International Consensus Conference (Diabetes Surgery Summit) was held in Rome, Italy, where international scientific authorities established a set of recommendations and called for a multidisciplinary effort to prioritize research in this emerging field.
To continue the multidisciplinary dialogue and translate scientific findings into policy changes, the 1st World Congress will bring together, for the first time, clinicians, scientists and policy makers. Together, they will craft an agenda of health policy initiatives in order to ensure access to approved treatments and prioritize further research in this field.
The Congress has received endorsements from the International Diabetes Federation (IDF) through its Taskforce on Epidemiology and Prevention, the European Association for the Study of Diabetes (EASD), the American Association of Clinical Endocrinologists (AACE), Diabetes-U.K., the American Society for Metabolic and Bariatric Surgery (ASMBS), the International Federation for the Surgery of Obesity and Metabolic Diseases (IFSO) and many other prestigious organizations from Latin America, Europe, Asia and the United States.
"It is very timely and appropriate that major scientific organizations start to carefully evaluate available evidence and to encourage initiatives such as the World Congress that promote a rigorous, multidisciplinary approach to this field," says Professor Sir George Alberti, diabetologist at the Imperial College in London, U.K., and Congress faculty member. "There are opportunities and risks that cannot be ignored, and both need to be adequately addressed."
The emerging field of diabetes surgery is receiving increasing attention worldwide not only for its clinical implications but also for bringing about an entirely new way to look at diabetes. Dr. David Cummings, endocrinologist at the University of Washington and Congress faculty member, states, "The insights already beginning to be gained by studying surgical interventions may be the most profound since the discovery of insulin."
"Surgery has arrived like a comet across the firmament of diabetes and obesity — unexpected, brilliant, with great promise for the future. Teams of talented researchers are moving ahead to define the role of surgery in the treatment of both of these scourges," says Dr. Jesse Roth, Congress faculty member, researcher, and diabetologist at the Feinstein Institute for Medical Research and the Albert Einstein College of Medicine of Yeshiva University in New York.
Diabetes surgery might also be a way to reduce health care spending across private and public health sectors. At the 1st World Congress, cost-effectiveness analysis and public health implications of diabetes surgery will be discussed for the first time with policy makers and top health authorities from the U.S., U.K. and worldwide.
"Diabetes is growing at epidemic rates worldwide and places a severe burden on the economy and society," says Dr. Paul Zimmet, Congress faculty member, diabetologist and director emeritus and director of International Research, Baker IDI Heart and Diabetes Institute in Melbourne, Australia. "However, issues may be very different in developed versus developing regions of the world. Organizing a World Congress to discuss the potential role of an emerging and yet-controversial approach to diabetes is very appropriate, and there are both global and regional perspectives that must be considered."
Diabetes affects an estimated 24 million Americans and 246 million people worldwide, a number that is expected to grow to 380 million by 2025. According to the American Diabetes Association (ADA), the disease could lower the average life expectancy of Americans for the first time in more than a century. Costs to treat diabetes are skyrocketing as well. According to a recent study commissioned by the ADA, diabetes costs Americans $174 billion annually, an increase of 32 percent since 2002. Health experts predict that one of every three children born after the year 2000 will have diabetes in their lifetime. In some communities like New York City, that number is one of every two in certain ethnic groups. Even with good medical management, diabetes often leads to cardiovascular disease, kidney failure, and premature death.
THE 1ST WORLD CONGRESS ON INTERVENTIONAL THERAPIES FOR TYPE 2 DIABETES
The 1st World Congress on Interventional Therapies for Type 2 Diabetes is a comprehensive and multidisciplinary forum where leaders in the global health community will conduct an organized review and discussion of the latest scientific data and theories on the use of bariatric surgery for the treatment of type 2 diabetes. The Congress, hosted by Weill Cornell Medical College and NewYork-Presbyterian Hospital, aims to create a forum for the medical community to work with health policy makers, including top public health authorities and insurers from the U.S. and around the world. The overarching aim is to craft an agenda of health policy initiatives to seize the opportunity offered by gastrointestinal surgery and novel interventional therapies for the understanding and treatment of diabetes. For more information, visit www.interventionaldiabetology.org.
NEWYORK-PRESBYTERIAN HOSPITAL/WEILL CORNELL MEDICAL CENTER
NewYork-Presbyterian Hospital/Weill Cornell Medical Center, located in New York City, is one of the leading academic medical centers in the world, comprising the teaching hospital NewYork-Presbyterian and Weill Cornell Medical College, the medical school of Cornell University. NewYork-Presbyterian/Weill Cornell provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine, and is committed to excellence in patient care, education, research and community service. Weill Cornell physician-scientists have been responsible for many medical advances — from the development of the Pap test for cervical cancer to the synthesis of penicillin, the first successful embryo-biopsy pregnancy and birth in the U.S., the first clinical trial for gene therapy for Parkinson's disease, the first indication of bone marrow's critical role in tumor growth, and, most recently, the world's first successful use of deep brain stimulation to treat a minimally-conscious brain-injured patient. NewYork-Presbyterian, which is ranked sixth on the U.S.News & World Report list of top hospitals, also comprises NewYork-Presbyterian Hospital/Columbia University Medical Center, Morgan Stanley Children's Hospital of NewYork-Presbyterian, NewYork-Presbyterian Hospital/Westchester Division and NewYork-Presbyterian Hospital/The Allen Pavilion. In its commitment to global health and education, Weill Cornell has a strong presence in places such as Qatar, Tanzania, Haiti, Brazil, Austria and Turkey. Through the historic Weill Cornell Medical College in Qatar, Cornell University is the first in the U.S. to offer a M.D. degree overseas. For more information, visit www.nyp.org and www.med.cornell.edu.
The 1st World Congress will be held on September 15-16, 2008, at the New York Marriott Marquis in Times Square. To register for the Congress and for more information, visit www.interventionaldiabetology.org.
John Rodgers
jdr2001@med.cornell.edu