Diabetes, as we all know, has become more and more common around us, and what is even more frightening is that in recent years, the growth rate of diabetics is almost comparable to the growth rate of China’s GDP, and according to information the number of diabetics in China is close to 100 million! The late stages of diabetes will certainly be accompanied by damage to the eyes, kidneys, blood vessels, heart and other organs, resulting in disability and death to patients and their families, as well as society to bring an extremely heavy economic and mental burden. The research of diabetes has become the focus and hot spot in the medical research field today, however, it is encouraging to see that scholars at home and abroad have finally harvested fruitful results from years of tireless research, and the breakthroughs in the research of diabetes mechanism have created many new ideas for clinical treatment. One of the major discoveries is “diabetes surgery”, which has been gaining more and more attention and being promoted in recent years. The good and irreplaceable long-term effect of “diabetes surgery” has made this surgery more and more accepted by patients, and for this reason, Europe and the United States have included surgery in the treatment guidelines for diabetes, and China has also included surgery in the treatment guidelines for diabetes after meticulous discussion by experts in previous years. After decades of evidence-based medical research and exploration, surgery has finally been found to be a good remedy for diabetes. The development of medicine and the innovation of treatment became the hope of overcoming diabetes. Years of medication have led to a bottleneck in the treatment of diabetes, and surgery is increasingly becoming an effective measure in the treatment of diabetes, with good results after surgery bringing new hope to diabetic patients and doctors treating diabetes. The improvement and remission of diabetes through surgical treatment began with gastric bypass surgery for morbid obesity, when it was discovered by chance that patients with combined 2 diabetes lost significant weight after surgery and their blood glucose quickly returned to normal, even in some cases without the need for glucose-lowering medications. Subsequently, a series of studies were conducted to confirm that after surgery for obesity, the number of patients with 2 diabetes who did not require medication to lower their blood sugar and who maintained normal blood sugar over time was significantly higher than in the non-surgical group, and that the incidence of diabetes-related complications and mortality were greatly reduced. How did the surgery manage to control the blood sugar of diabetic patients? The surgery firstly controls the amount of food eaten by reconstructing a small gastric sac (usually not more than 50ml), which can effectively reduce body weight, increase cellular sensitivity to insulin, and reduce insulin resistance and promote better insulin function, which is easily understood by everyone. Secondly, surgery can reconstruct the intestinal sequence, which can make corresponding changes in gastrointestinal hormone secretion and lower blood sugar level. Surgery can regulate the secretion of endocrine hormones to control blood glucose, which is not as well understood as reconstructing a small gastric sac, and there is a lot to learn here. To better understand this mechanism, we have to go back to the roots and look for answers from history. Nowadays, it is believed that the lack of abundance of food, the roughness of food, the small amount of food eaten, and the roughness of food eaten easily through the entire digestive tract have become one of the main reasons why we stay away from diabetes, and for this reason some experts and scholars believe that diabetes is a disease of intestinal origin. Our blood glucose regulation is the result of the combined effect of various hormones secreted by the endocrine organs in the body, and the pancreas and the gastrointestinal tract are considered important organs with important endocrine functions. Simply put, the hormones that regulate blood glucose in the body are divided into two categories, one is the hormone that raises blood glucose and the other is the hormone that lowers blood glucose, just like the weights in the two pallets of a balance, the change of which side of the weights will change the balance of the balance. A decrease in the secretion of hypoglycemic hormones or an increase in the secretion of hyperglycemic hormones will tip the balance in favor of the hyperglycemic side. Current research suggests that the primary result of hormone secretion in the proximal gut is to cause an increase in blood glucose, while the effect of hormone secretion in the distal gut results in a decrease in blood glucose. Surgery results in increased stimulation of the distal intestine by food, which increases the secretion of hypoglycemic hormones, and decreased stimulation of the proximal intestine, which decreases the secretion of hyperglycemic hormones, and blood glucose is eventually regulated to normal levels. In addition, surgery can lower blood glucose by other means such as reducing the secretion of Gelin hormone. Of course, surgery is not a foolproof solution, it is not suitable for all diabetic patients, this treatment is only suitable for some diabetic patients. Simply put, surgery is suitable for patients who are generally obese, with a body mass index of 28 or more, who are not older than 65 years old, or who have a large abdominal circumference (>85cm for women and >90cm for men), who have a pancreatic impairment of no more than 50%, and who, of course, have good heart and lung function and other organs that can tolerate surgery. Medicine is an empirical discipline and development never stops. No treatment can be said to be to the extent that no further improvement is needed, and no treatment can be said to be absolutely free of any risk. As an indication for diabetes surgery, surgery to treat diabetes is a good choice.