A new study published in The Lancet Diabetes and Endocrinology suggests that obese patients with type 2 diabetes, especially those with recent disease flares, should have bariatric surgery more often than obese patients without type 2 diabetes, given the total cost of care. Because many patients have reversals of their diabetes after surgery, they need fewer expensive diabetes medications or treatments to cope with complications, experts say. The vast majority of current health systems prioritize bariatric surgery based on a person’s body mass index (BMI), with those with the highest BMI generally receiving the highest priority. Patients with a low BMI and coexisting conditions such as type 2 diabetes may also be considered eligible for surgery, but guidelines vary from country to country. The SOS study was conducted in the Swedish health care system and included 2010 adults who underwent bariatric surgery and 2037 controls between 1987 and 2001. The data showed a nonsignificant difference between non-diabetic patients who did not have surgery for 15 years and controls, but reduced costs for those with antecedent diabetes (mean -$3329) or diabetes (-$5487) who did have surgery. However, for all patients who had surgery, hospital costs were higher. No difference in outpatient costs was observed. Diabetes reduction also meant fewer diabetes complications and thus fewer future medical costs compared to patients treated conventionally. Total medical costs were higher for surgery patients who did not have diabetes at the start of the study or for patients with antecedent diabetes, most likely because diabetes remission often occurs after bariatric surgery, which means fewer diabetes medications and hospital appointments in subsequent years. Diabetes remission also means fewer complications from diabetes, which in turn reduces future medical costs.