New Delhi: Even as India and China top the global chart of obese and diabetic people, experts charted out five prerequisites for patients and surgeons before weight loss surgery, doctors said.

"Over the years, there has been a lot of international attention on metabolic surgery. And with increasing problems of obesity, these guidelines will also help diabetic patients in understanding whether they can choose bariatric surgery as an option to cure their problem," said Muffazal Lakdawala, founder, Centre for Obesity and Diabetes Surgery (CODS).

In the task force meet of the fifth Asian consensus meeting on metabolic surgery, top metabolic surgeons and diabetologists from across the globe came out with the list of requisites.

The prerequisites that doctors have come with are: the metabolicsurgery team must be a multidisciplinary team and patients who undergo surgery need life-long follow up by the diabetologist/endocrinologist/bariatric physician and a nutritionist.

The prerequisites defined various limits of the basic metabolic index (BMI) of the patient eligible for the surgery, holding that patients of type two diabetes with less than a BMI of 30 must be offered surgery only under experimental protocol.

Metabolic surgery must be performed only at high volume centres performing more than a 100 procedures in a year, the list added.

According to the Diabetes Atlas by the IDF, China had overtaken India as the "Diabetes Capital of the World" last year. U.S stands third in the list with over 23 million diabetics..

While bariatric surgery is the most suggested treatment mode for obese people, the IDF last year called for the surgery to be considered earlier in the treatment of eligible obese diabetic patients.

Aprospective trial is going to be started comparing the results of surgery with medical management to see the effects on micro and macrovascular complications of diabetes in these patients, the task force added.