A recent study tracked 20,000 severely obese patients with Type 2 Diabetes and found that those who had weight loss surgery had a 40% lower chance of developing a heart attack or stroke in the five years following surgery compared to those who were managed medically. They patients who had surgery had gastric sleeve, gastric band or gastric bypass. These surgeries cost $20,000 to $25,000 and are generally covered by insurance. Surgery is thought to help by affecting hormones, gut bacteria and other substances that affect how the body handles insulin and 
blood sugar.
The improved lipid profile, the decrease in inflammatory cytokines and the resistin which antagonizes insulin secreted by visceral fat are likely behind the improvement. The new findings suggest insurance coverage be expanded for the right patients to result in substantial cost savings and improved patient outcomes.