Surgery? A Critical Analysis of the Evidence in 2010

The prevalence of type 2 diabetes hasmarkedly increased in the last de-cade worldwide, but in particular in Asian countries such as China and India (1–3), in strong correlation with a com-parably steep increase in the prevalence of obesity (4). The primary risk factor for type 2 diabetes is obesity, and 90 % of all patients with type 2 diabetes are over-weight or obese. The relative risk of dia-betes increases about 42-fold in men as the BMI increases from,23 kg/m2 to.35 kg/m2 (5) and approximately 93-fold in women as BMI increases from,22 kg/m2 to.35 kg/m2 (6). Type 2 diabetes is a complex major endocrine disorder in which insulin re-sistance in the muscle and liver as well as b-cell failure represent the core patho