Currently, China has become the country with the largest number of type II diabetes patients in the world. However, many people do not fully understand the dangers of diabetes, so much so that they do not pay attention to it even after being detected. Unbeknownst to them, this may lay a huge hidden danger to their health. Patients with type II diabetes have a two to four times higher risk of cardiovascular mortality and stroke than the general population, and eight out of every 10 diabetics die from cardiovascular events. Diabetic neuropathy is the leading cause of non-traumatic lower extremity amputations. Diabetes also causes retinopathy, which eventually leads to blindness. In addition, diabetic nephropathy is a major hazard of type II diabetes. As you can see, it is crucial to actively control blood glucose and prevent complications. In the past, diabetes was a medical disease and was mostly treated with drugs or insulin injections, and the treatment was not as effective as it should be. However, with the continuous development of medicine, gastric diversion surgery for the treatment of type II diabetes has gradually come into the limelight. The American Journal of Medicine has conducted a meta-analysis of 136 papers published over a 13-year period, with a total of 22,094 patients, to prove the efficacy of the procedure. The study found that 76.8% of obese type II diabetes was completely cured by gastric diversion surgery, and 86% of patients showed significant improvement. In fact, gastric diversion surgery for diabetes is a “beautiful accident”. The procedure was first used for weight loss, and after 14 years of clinical follow-up, Dr. Pories unexpectedly discovered in 1995 that the procedure was effective in lowering blood glucose and was superior to medications for lowering sugar. After that, the medical community began to use gastric diversion surgery to treat diabetes. By altering the flow of food, the procedure affects the patient’s endocrine mechanisms and ultimately leads to the treatment of type II diabetes. It has been found that the surgery can benefit patients to a great extent by solving their blood glucose problems without the need for insulin injections, let alone multiple medications, after the surgery, and by significantly improving diabetes complications such as hypertension, obesity and dyslipidemia. At present, the World Diabetes Federation has officially issued a statement recognizing surgery as one of the effective means of diabetes treatment, and gastric diversion surgery has become one of the internationally recognized standard procedures. One may ask, after all, surgery is an invasive treatment and there are definitely risks involved, so should diabetes surgery be the treatment of choice or just a life-saver for those with poor control? In response to this question, the 2011 edition of the International Diabetes Federation (IDF) has clear indications for surgery: for patients with type II diabetes with a BMI (body mass index) ≥ 35 kg/m2, surgery is recommended as the first choice; for patients with a BMI of 30 ≤ 35 kg/m2 and whose diabetes cannot be effectively controlled with optimal drug therapy, surgery is recommended; for Asian patients with a BMI Since there are no authoritative guidelines for surgery for obese type II diabetes in China, only minor adjustments can be made with reference to international standards. Surgery for diabetes has been widely used in many countries, and about 20,000 patients in the United States are effectively treated through surgery each year. However, in China, this method has not yet been popularized due to insufficient awareness and lagging information. In fact, there is no gap between our country and foreign countries in terms of surgical methods and skills, which are performed with laparoscopy. Therefore, for obese type II diabetes, the risk of poor glycemic control is much higher than the risk of surgery, and surgery should be used as early as possible. As long as a standardized medical institution is chosen, the indications for surgery are strictly followed, and meticulous and thoughtful postoperative follow-up and monitoring is done, safety can be guaranteed. In addition, in addition to the gastric diversion surgery we introduced above, sleeve gastrectomy for diabetes has also achieved very good results in recent years. What’s more, because of the low risk of this surgical procedure, it is especially suitable for the application in highly obese and high-risk patients. To promote the development of surgical treatment of diabetes in China and benefit more patients, it is still necessary for medical and surgical doctors to cooperate and actively cooperate, to better promote communication and collaboration between related specialties, to explore future preventive and control measures for diabetes, and to further improve clinical diagnosis and treatment and comprehensive prevention and treatment of the patient population.