With the reaffirmation of metabolic surgery for effective treatment of type 2 diabetes in the Chinese Diabetes Prevention and Control Guidelines (2017 edition), weight loss metabolic surgery has become a more preferable treatment for diabetes than traditional internal medicine. So is every diabetic patient suitable for surgery? The treatment of diabetes has not received the attention it deserves in China, and there are far more undiagnosed diabetics than diagnosed ones. The treatment effect of internal medicine on type 2 diabetes is extremely poor, and the highest sample survey proves that only 27-35% of diabetic patients can control their sugar to meet the standard, and most of them are progressively aggravated. Diabetes is not only difficult to control blood sugar, but also brings great inconvenience to life, such as insulin, preservation and carrying of insulin in hot weather, and strict diet control, etc. In the words of our patients: there is no quality of life with diabetes, and it feels like death is approaching step by step, especially nowadays, the age of diabetes patients is moving forward, and more and more young diabetes patients are becoming the main force. The difference between Chinese and Western indications for diabetes surgery In China, there are differences between the basic conditions of diabetic patients and Western populations, mainly in that Chinese diabetic patients are not as obese as Western patients, Chinese diabetic control is worse, Chinese patients are less compliant, Chinese diabetic patients have more abdominal obesity and more serious complications, so they cannot follow the Western indications for surgery. So, which Chinese diabetic patients are suitable for surgical treatment? Physicians and surgeons in mainland China as well as in Taiwan and other Asian countries have conducted relentless exploration and research, which is now combined with the release of China’s 2014 guidelines for the surgical treatment of obesity and diabetes and summarized in the literature as follows: For Chinese diabetic patients, if your weight meets the criteria for obesity (BMI = weight kg / height m squared) > 30 and you have poor glycemic control, it is recommended that you Surgery, 85% of patients will recover completely, get rid of glucose-lowering drugs, and will improve blood lipids, blood pressure and other complications. If your BMI is >25 and your islet function is good and your blood sugar is not well controlled, then surgery is also recommended. Of course, your doctor will evaluate your islet cell function before surgery, and for those patients with a BMI of 35 or more it is even more strongly recommended that you receive surgery immediately. The Chinese Guidelines for the Surgical Treatment of Obesity and Diabetes (2014) stipulate that diabetic patients who meet the following conditions can undergo diabetes surgery: Duration of type 2 diabetes ≤ 15 years, and the pancreatic islets still have some insulin-secreting function, and fasting serum C-peptide ≥ 1/2 of the lower limit of normal. BM (body mass index) ≥ 27.5 kg/m2. The recommended grade of surgery can be increased at the discretion of men with waist circumference ≥ 90 cm and women with waist circumference ≥ 85 cm. The recommended age for surgery is 16-65 years.