In recent years, there has been a proliferation of diabetes treatment drugs, but traditional drug-based treatment often does not achieve very satisfactory results for obese type 2 diabetic patients, and the pressure to lose weight and the weight gain caused by drugs is still a confusion for these patients. In the 1980s, U.S. doctors were surprised to find that their patients’ blood glucose dropped after bariatric surgery in obese patients with combined diabetes. Many subsequent studies have also confirmed that bariatric surgery can lead to remission of diabetes, thus creating a new avenue of surgical treatment for type 2 diabetes. But diabetes surgery is still relatively unknown to Chinese patients. So, how does bariatric surgery achieve the effect of treating type 2 diabetes? The mechanism is not yet very clear, but it is generally believed that the surgery reduces food intake and absorption, reduces energy, thus consuming its own excess fat and increasing insulin sensitivity. Moreover, the reconstruction of the gastrointestinal tract changes the secretion of hormones in the intestinal-insulin axis, which affects the secretion of some hormones and thus reduces blood sugar. What type of bariatric surgery is used? There are two types of bariatric surgery most commonly used in China, one is gastric bypass bariatric surgery and the other is sleeve gastrectomy (also known as tubular gastric surgery and gastric reduction surgery). Both types of surgery have their own advantages and disadvantages and should be chosen carefully according to your situation. What kind of people are suitable for bariatric surgery? Bariatric surgery is suitable for people aged 18-60 who are in good health, have difficulty controlling blood sugar with lifestyle interventions and medications, and have a BMI ≥ 32 kg/m2 for obese people with type 2 diabetes. What do I need to pay attention to after bariatric surgery? Diet and exercise are still required to maintain weight after bariatric surgery, and long-term vitamin and iron supplements are needed. In conclusion, evidence of the effectiveness and safety of bariatric surgery is gradually increasing, and surgery for diabetes is changing the landscape and perception of diabetes treatment, but it should also be known that bariatric surgery is not suitable for all diabetic patients, nor is it 100% effective, only some diabetic patients are in remission, and bariatric surgery has its side effects. Therefore, it is important to go to a regular three hospitals with mature technology to receive treatment from professional physicians, and not to blindly perform surgery.