title: Physicians' attitudes about referring their type 2 diabetes patients for bariatric surgery.
abstract: BACKGROUND
  Despite increasing evidence about the beneficial effects of bariatric surgery, little is known about physicians' attitudes toward it as a treatment of type 2 diabetes. Our objective was to investigate physicians' attitudes about referring patients with type 2 diabetes for bariatric surgery.
  
  
  METHODS
  Physicians were identified from the Pennsylvania Integrated Clinical and Administrative Research Database and other databases. Physicians at an academic medical center (n = 142) and community-based physicians (n = 197) in the Philadelphia area in specialties likely to treat type 2 diabetes were sent a survey about their perceptions of the safety and efficacy of bariatric surgery as a treatment for obesity and type 2 diabetes.
  
  
  RESULTS
  Of the physicians, 93 returned the survey, for a combined response rate of 27.4%. Respondents reported having positive impressions of bariatric surgery as a treatment for obesity and type 2 diabetes (79.6% and 67.4%, respectively). Only 20.8% of respondents indicated that they would be likely to refer their patients with type 2 diabetes with a body mass index of 30-34.9 kg/m(2) to a randomized research trial of bariatric surgery.
  
  
  CONCLUSIONS
  In general, physicians who treat patients with type 2 diabetes had favorable impressions about bariatric surgery as a treatment for obesity and type 2 diabetes. However, only a few were willing to refer their patients with type 2 diabetes and a body mass index of 30-34.9 kg/m(2) to randomized research trials of bariatric surgery. This reluctance to refer patients represents an important barrier to the successful completion of studies of the efficacy of bariatric surgery for those with type 2 diabetes and a body mass index <35 kg/m(2).
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania 19104, USA. dsarwer@mail.med.upenn.edu
authors.forename: David B
authors.initials: DB
authors.lastname: Sarwer
authors.forename: Scott
authors.initials: S
authors.lastname: Ritter
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Wadden
authors.forename: Jacqueline C
authors.initials: JC
authors.lastname: Spitzer
authors.forename: Marion L
authors.initials: ML
authors.lastname: Vetter
authors.forename: Reneé H
authors.initials: RH
authors.lastname: Moore
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D050110:Bariatric Surgery; D003924:Diabetes Mellitus, Type 2 / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D010414:Pennsylvania; D010820:Physicians / Q000523:psychology*; D016032:Randomized Controlled Trials as Topic; D012017:Referral and Consultation