Dr. Avinash Tank Invited as Faculty for Cross-Speciality Talk with Dr. Jimit Vadgama at SwasthyaCON 2025

Dr. Avinash Tank Invited as Faculty for Cross-Speciality Talk with Dr. Jimit Vadgama at SwasthyaCON 2025

Dr. Avinash Tank, Senior Consultant in Liver, Gastro & Bariatric Surgery at xApollo Hospital, Ahmedabad, was invited as a faculty member for a cross-speciality session at SwasthyaCON 2025. He shared the stage with Dr. Jimit Vadgama, a leading diabetes physician from Surat, to discuss “Obesity Management in Diabetes: Bariatric Surgery & Pharmacological Treatments.” This session highlighted the interdisciplinary approach needed for managing obesity and Type 2 Diabetes (T2D) effectively.

The talk focused on the role of metabolic (bariatric) surgery in treating T2D, particularly in patients with obesity, and emphasized the growing evidence supporting early surgical intervention as a game-changing treatment modality.

The Increasing Need for a Cross-Speciality Approach in T2D Management

The dual epidemic of obesity and diabetes has created an urgent need for innovative, multidisciplinary treatment strategies. Traditional pharmacological management often fails to achieve sustained glycemic control and weight loss in patients with a high body mass index (BMI). During the session, Dr. Tank and Dr. Vadgama discussed how metabolic surgery and pharmacological treatments can complement each other to provide superior outcomes.

The session reinforced the importance of collaboration between surgeons and diabetologists, as well as the integration of surgical interventions in diabetes treatment protocols.

Criteria for Recommending or Considering Metabolic Surgery

Dr. Tank outlined the following criteria based on current guidelines:

1. When to Recommend Surgery:

• Patients with BMI ≥ 35 kg/m² at the time of consultation.

• Persistent BMI ≥ 35 kg/m² despite intensive treatment by diabetologists or obesity specialists for six months or more.

2. When to Consider Surgery:

• Patients with BMI ≥ 32 kg/m² who:

• Have not achieved ≥ 5% weight loss, or

• Have achieved weight loss but continue to experience poor glycemic control (HbA1c > 8.0%) despite six months or more of treatment.

Dr. Tank emphasized that metabolic surgery should not be seen as a last resort but rather as an early treatment option for eligible patients.

Why Early Surgery is Better

One of the key takeaways from Dr. Tank’s presentation was the critical importance of early surgical intervention in T2D management. Early metabolic surgery is often more effective than prolonged intensive medical treatments and offers significant long-term benefits.

• Preservation of Beta Cells:

Early surgery helps preserve the beta cells of the pancreas, which are vital for insulin production. Long-standing uncontrolled hyperglycemia damages these beta cells, leading to worsening diabetes. Surgical interventions can mitigate this damage and improve metabolic outcomes.

• Improved Glycemic Control:

Metabolic surgery induces hormonal and physiological changes that improve insulin sensitivity and glycemic control, reducing dependence on medications.

• Sustained Weight Loss:

Unlike pharmacological treatments, which often result in temporary or limited weight loss, metabolic surgery offers sustained weight reduction, a key factor in diabetes management.

Scientific Evidence Supporting Metabolic Surgery

Dr. Tank reviewed the evolution of diabetes surgery and its effectiveness. He highlighted the physiological mechanisms that drive improvements in insulin sensitivity, gut hormone regulation, and systemic inflammation post-surgery.

Key Findings:

• Bariatric procedures like Roux-en-Y gastric bypass and sleeve gastrectomy show significant reductions in HbA1c levels.

• These procedures also result in improvements in lipid profiles, blood pressure, and overall cardiovascular health.

• Long-term studies demonstrate that metabolic surgery not only reduces the need for diabetes medications but also decreases the risk of diabetes-related complications.

Dr. Tank emphasized the growing body of evidence supporting surgery as a transformative treatment option for obesity-related diabetes.

The Importance of a Collaborative Approach

Dr. Jimit Vadgama highlighted the essential role of diabetologists and physicians in identifying suitable candidates for metabolic surgery. A collaborative approach between surgeons and medical professionals ensures:

1. Early diagnosis of patients who may benefit from surgery.

2. Comprehensive pre-surgical assessments, including glycemic control and co-morbidities.

3. Post-surgical care focusing on nutritional guidance and pharmacological adjustments.

The session underscored the need for physicians to integrate metabolic surgery into their treatment strategies for eligible patients, rather than relying solely on pharmacological management.

Conclusion of the Talk

Dr. Tank and Dr. Vadgama concluded the session by reaffirming that metabolic surgery is not merely a weight-loss procedure but a scientifically validated treatment for Type 2 Diabetes, especially in patients with obesity. They highlighted the dual benefits of surgery in achieving glycemic control and addressing obesity-related complications.

Key Message for Practitioners:

• Physicians and diabetologists should proactively identify patients who meet the criteria for metabolic surgery and refer them to experienced bariatric surgeons.

• Early intervention is crucial to prevent irreversible damage to beta cells and to improve long-term outcomes for patients.

• Interdisciplinary collaboration is essential for maximizing the benefits of both surgical and medical treatments.

Takeaways for Practicing Physicians and Diabetologists

1. Adopt Early Intervention: Consider metabolic surgery early in the treatment pathway for eligible patients, rather than as a last resort.

2. Focus on Patient-Centric Care: Combine surgical and pharmacological approaches for a tailored treatment plan.

3. Collaborate Across Specialities: Work closely with bariatric surgeons to ensure comprehensive care, from pre-operative assessments to post-operative follow-ups.

4. Educate Patients: Inform patients about the benefits of metabolic surgery, including its potential to preserve beta-cell function and reduce long-term complications.

5. Stay Updated: Keep abreast of evolving guidelines and evidence to offer the best care to patients with obesity and diabetes.

Advancing the Field: A Call to Action

Dr. Avinash Tank’s participation in SwasthyaCON 2025 serves as a reminder of the importance of cross-speciality collaboration in advancing diabetes care. By integrating metabolic surgery into treatment protocols and encouraging early intervention, healthcare professionals can provide patients with a pathway to better health and improved quality of life.

For more insights and updates on innovative diabetes management strategies, visit www.swasthyacon.org.