Congress Program

2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 Hilton New York New York, NY USA Congress Director Francesco Rubino, MD Congress Program www.wcidt.org Hosted By

Welcome to the 2nd World Congress on Interventional therapies for Type 2 diabetes Dear Colleagues and Friends, Several gastrointestinal (GI) operations originally designed to treat morbid obesity also cause dramatic improvement or even remission of type 2 diabetes. The mechanisms by which surgery controls hyperglycemia remain elusive. Increasing evidence suggests that weight-independent mechanisms may play a role in the surgical control of diabetes. This knowledge challenges current paradigms of disease pathogenesis and points to the gastrointestinal tract as a potential target for the development of less invasive interventional therapies and novel pharmaceuticals. Previously, the Diabetes Surgery Summit (Rome 2007) and the 1st World Congress on Interventional Therapies for Type 2 Diabetes (New York 2008), have raised attention about the role of gastrointestinal surgery for the treatment of diabetes: opportunities and limitations of this emerging field are now the matter of a growing debate. The debate continues with the 2nd World Congress on Interventional Therapies for Type 2 Diabetes. A multidisciplinary group of clinicians, scientists and policy makers will address barriers that still prevent access to surgical treatment of diabetes in eligible patients and develop an agenda of research priorities to improve patients selection and elucidate mechanisms of diabetes control. A stellar Faculty of leading international scientists will also discuss how the lessons learned from study of gastrointestinal interventions may improve understanding of diabetes and provide a lead for future treatments of curative intent. On behalf of the organizing committee and myself, I welcome you to this exciting, multidisciplinary event. Francesco Rubino, MD Congress Director 1

2nd World Congress on Interventional Therapies for Type 2 Diabetes EDUCATIONAL PARTNER American Diabetes Association ENDORSING SOCIETIES The 2nd World Congress on Interventional Therapies for Type 2 Diabetes is endorsed by the following organizations. 100SW 75th Street Suite 201 Gainesville, FL 32607 American Association of Clinical Endocrinologists American Association of Endocrine Surgeons American Gastroenterological Association American Society for Metabolic and Bariatric Surgery Asociacion De Cirugia Bariatrica Y Metabolica De Guatemala Asia Pacific, Metabolic & Bariatric Surgery Society Asociation Latinoamericana De Circurjanos Endoscpistas Association for the Study of Obesity Belgian Endocrine Society Canadian Diabetes Association Diabetes UK Emirates Obesity Surgery Interest Group European Association for Gastroenterology and Endoscopy European Association for the Study of Diabetes IFSO Sweden Indian Association of Gastrointestinal Endo-Surgeons International Atherosclerosis Society Endocrine Society European Association for Endoscopic Surgery International Federation for the Surgery of Obesity and Metabolic Disorders 2 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org

2nd World Congress on Interventional Therapies for Type 2 Diabetes Italian Society of Endocrinology Japan Society for the Study of Obesity National Obesity Forum The New York Academy of Sciencs Obesity & Metabolic Surgery Society of India The Obesity Society Obesity Surgery Society of Australia & New Zealand The Philippine Society for Metabolic and Bariatric Surgery Qatar Diabetes Association Qatar Foundation Research Society for the Study of Diabetes in India Sociedad Argentina de Diabetes Sociedade Brasileira de Cirurgia Bariatrica e Metabolica Sociedade Brasileira de Diabetes (SBD) Sociedade Brasileira de Endocronologia e Metabologia Sociedad de Cirujanos de Chile Sociedad Espanola de Diabetes Società Italiana di Diabetologia Società Italiana dell'obesità Società Italiana di Chirurgia dell Obesità e delle malattie metaboliche Società Italiana per la Prevezione Cardiovascolare Society for Endocrinology Society of American Gastrointestinal and Endoscopic Surgeons The Society for Surgery of the Alimentary Tract Swiss Society for the Study of Morbid Obesity and Metabolic Disorders This program is supported in name only by the American Heart Association s Councils on Basic Cardiovascular Sciences, Clinical Cardiology, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, Kidney in CV Disease, and High Blood Pressure Research. http://www.heart.org/heartorg/ 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 3

The International Diabetes Federation (IDF) Position Statement on Interventional Treatments of Type 2 Diabetes During the World Congress, the IDF will officially announce its Position Statement on Metabolic/Bariatric Surgery and GI Interventions for the Treatment of Diabetes Monday, March 28, 2011 11:10 am - 12:30 pm Grand Ballroom, Hilton New York The IDF consensus developing meeting was held at the IDF head office in Brussels, Belgium (5-6 December, 2010). This meeting was convened by: Professor George Alberti Imperial College, London and Newcastle University, UK Professor John B. Dixon Baker IDI Heart & Diabetes Institute, Melbourne, Australia Professor Paul Zimmet Baker IDI Heart & Diabetes Institute, Melbourne, Australia Professor Francesco Rubino Weill Cornell Medical College, New York, NY, USA Professor Stephanie Amiel King's College London, UK Professor Louise A. Baur University of Sydney, Australia Professor Nam H. Cho Ajou University School of Medicine, Korea Dr. Bruno Geloneze University of Campinas (UNICAMP), Brazil Professor Jan Willem Greve Atrium Medical Center, Netherlands Professor Linong Ji Peking University People's Hospital, China Dr. Muffazal Lakdawala Saifee Hospital, India Professor Wei-Jei Lee Ming-Sheng General Hospital, National Taiwan University, Taiwan Other attendees at the meeting were: Professor Pierre Lefebvre IDF and University of Liege, Belgium Dr. Carel Le Roux Imperial College London, UK Professor Jean-Claude Mbanya International Diabetes Federation, Cameroon Professor Gertrude Mingrone Catholic University of Rome, Italy Professor Philip R. Schauer Cleveland Clinic Lerner College of Medicine, USA Professor Luc Van Gaal Antwerp University Hospital, Belgium Dr. David Whiting International Diabetes Federation, Belgium Professor Bruce M. Wolfe Oregon Health and Science University (OHSU), USA All panel members made a substantial contribution to the meeting and subsequent formulation of the position statement. The consensus meeting was supported with an unrestricted educational grant by: Allergan Inc, Irvine, CA, USA Ethicon, Ethicon Endo-Surgery, Inc, Cincinnati, Ohio, USA MetaCure Inc, Mount Laurel, NJ, USA These companies played no role in the discussion or preparation of the IDF position statement. 4 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org

2nd World Congress on Interventional Therapies for Type 2 Diabetes Contents Welcome................................... 1 Endorsing Societies............................ 2-3 International Diabetes Federation Statement............... General Information............................ 4 6-7 Congress Advisory Committee....................... 9 Congress Program Committee..................... 11-13 Distinguished Faculty.......................... 14-21 Guest Experts................................ 22 Program-At-A-Glance......................... 23-24 PROGRAM Monday, March 28.......................... Tuesday, March 29.......................... 26-27 28-32 Breakout Sessions/Workshops................... 30-32 Wednesday, March 30........................ 33-34 Faculty Index................................. 35 Exhibitor Directory............................ 37-38 Exhibit Floor Plan.............................. 38 Poster Sessions.............................. 39 Diabetes: A Global Epidemic....................... 41 Gastrointestinal Procedures...................... 43-47 Disclosures............................... 48-49 Congress Sponsors............................. 50

GENERAL INFORMATION The World Congress will take place March 28-30, 2011 at the Hilton New York, 1335 Avenue of the Americas, New York, NY 10013 Telephone: (+1) 212-586-7000 Guest Fax: (+1) 212-315-1374 EDUCATIONAL DISCLAIMER The primary purpose of this congress is education. Information presented, as well as publications, technologies, and/or services discussed, are intended to inform you about the knowledge, techniques, and experiences of the faculty who are willing to share such information with colleagues. A diversity of professional opinions exists on the topics of the Congress, and the views of the conference s faculty are solely for educational purposes. Faculty s views neither represent those of the 2nd World Congress on Interventional Therapies for Type 2 Diabetes nor constitute endorsement by the endorsing societies listed in this syllabus. The Congress declaims any and all liability or damages to any individual attending this conference and for all claims, which may result from the use of information, publications, technologies, products and/or services of the meeting. Faculty disclosure statements have been provided by speakers and are included at the end of this syllabus. ACCREDITATION Due to the structure and multidisciplinary nature of the Congress, continuing medical education and nursing credits are not available through the Congress this year. GUIDE TO MEETING ROOMS Second Floor Promenade - World Congress Registration Clinton Suite - Press Office Gibson Suite - Speaker Ready Room Rhinelander Gallery - Exhibits, Poster Sessions, Continental Breakfasts and Lunches Sutton Center - Breakout Sessions Sutton North/Beekman - Breakout Sessions Sutton South/Regent - Breakout Sessions Third Floor Grand Ballroom - Opening Ceremony, Plenary Sessions Trianon Ballroom - Welcome Reception All meeting room floors being used for the World Congress are accessible by elevators. Escalators also provide access between First, Second, and Third Floors. SPEAKER READY ROOM All Congress speakers are required to check in at the Speaker Ready Room no later than two hours in advance of your presentation. The Speaker Ready Room is located in the Gibson Suite on the hotel s second floor. Speaker Ready Room Hours: Sunday, March 27, 2011 2:00 pm - 6:00 pm Monday, March 28, 2011 7:00 am - 6:00 pm Tuesday, March 29, 2011 6:30 am - 6:00 pm Wednesday, March 30, 2011 7:00 am - 12:00 pm REGISTRATION Registration Hours: Sunday, March 27, 2011 Monday, March 28, 2011 Tuesday, March 29, 2011 Wednesday, March 30, 2011 10:30 am - 7:00 pm 7:00 am - 9:00 pm 6:30 am - 7:00 pm 7:00 am - 2:00 pm Only registered participants may attend the Scientific Sessions and the Social Events offered by the World Congress. All registered participants are entitled to: Attend all Scientific Sessions Attend the Exhibits, and the Poster Sessions Receive Final Program and Abstracts Breakfast and Coffee Breaks March 28-30 and Boxed Lunches on March 28-29 BADGES The official badge must be worn for admission to all activities of the Congress. PRESS Working press from print and electronic media may receive complimentary registration on submission of a copy of press credentials and a completed registration form. A Press Office will be available in the Clinton Suite on the 2nd floor. Press Office Hours: Monday, March 28, 2011 Tuesday, March 29, 2011 Wednesday, March 30, 2011 7:00 am - 6:00 pm 7:00 am - 6:00 pm 7:00 am - 12:00 pm 6 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org

SCIENTIFIC EXHIBITS Scientific Exhibits and Posters will be located inside the Rhinelander Gallery on the hotel s second floor. Exhibit and poster hours are: Monday, March 28 7:00 am - 6:45 pm (Poster Session from 5:45 6:45 pm) Tuesday, March 29 6:30 am 3:00 pm LANGUAGE The official language of the Congress is English. No simultaneous translation is provided. WIFI HOTSPOT A wifi hotspot is offered to participants to remotely access Internet. The wifi hotspot is located inside the Rhinelander Ballroom. Funding for the 2nd World Congress wifi hotspot is graciously provided by Allergan. MEALS & COFFEE BREAKS Continental breakfast and box lunch will be available inside the Rhinelander Gallery on Monday and Tuesday. Coffee breaks, as well as Wednesday s continental breakfast, will be located in the Grand Ballroom Foyer. WELCOME RECEPTION Please join us for this unique opportunity to network with faculty, guest experts and colleagues. Areas of conversation will be nestled among tastes and flavors reminiscent of New York Neighborhoods. Relax and enjoy the music of the best cover band in New York City ~ Café Wha? ~ with your colleagues and friends to your favorite funk, classic rock, rhythm and and meringue dance music. Trianon Ballroom, Hilton New York Monday, March 28, 2011 8:00 pm - 10:00 pm Tickets to the Welcome Reception are available for purchase at the Registration Desk until 12:00 pm on Monday, March 28. A ticket and official Congress badge are required for admittance. CERTIFICATE OF ATTENDANCE A Certificate of Attendance is available upon request, from the Registration Desk at the end of the Congress. The request form may be found in your registration bag. BUSINESS CENTER A fully staffed Business Center is located on the 2nd floor of the New York Hilton, adjacent to Guest Elevators (next to the Madison Suite). Services include computer stations, Fax Services, Copy Machine, and Package Delivery. Business Center Hours: Monday - Friday Saturday & Sunday 7:00 am - 7:00 pm 9:00 am - 5:00 pm The Business Center may also be accessed 24 hours a day using your New York Hilton guest room key. The Business Center can be contacted though a house phone at Ext. 5212 or by calling (+1) 212-399-1977. LOST & FOUND Please return all lost or found items to the Registration Desk. All items left at the World Congress Lost and Found will be turned over to New York Hilton upon conclusion of the event. IN CASE OF EMERGENCY In the event of any emergency situation, dial extension 5747 or 66 from any house phone or your hotel room. New York Hilton has security personnel trained in first aid and CPR and a direct link to NYC emergency services such as ambulance and paramedics to render aid quickly. SMOKING The New York Hilton sleeping rooms, public and meeting space is 100% smoke-free. There is a Smoking Oasis out front of the Hotel on the main ramp. PERSONAL INSURANCE COVERAGE Registration for the World Congress implies that the participant agrees that neither the Organizing Committee (consisting of the Advisory and Program Committees), the Weill Cornell Medical College, the NewYork-Presbyterian Hospital nor the Giovanni Lorenzini Medical Foundation assume any liability or responsibility whatsoever. Congress delegates are requested to make their own arrangements for medical, travel, and personal insurance. CELLULAR PHONES, BEEPERS & ELECTRONIC DEVICES In consideration of fellow participants, it is requested that all cell phones, beepers, pagers, and other electronic devices be turned off or set to the silent/vibrate mode during all Scientific Sessions to avoid disruption. AMERICANS WITH DISABILITIES STATEMENT The World Congress wishes to take those steps to ensure that no individual with a disability is excluded, denied services, segregated, or otherwise related to differently because of the absence of auxiliary aids and services identified in the Americans with Disabilities Act. If any such services are necessary in order to participate in the Congress, please communicate your needs in advance. The Congress can assist with special needs (e.g. physical, dietary). For assistance, please stop by the Registration Desk. PROGRAM CHANGES AND MESSAGE BOARD A Program Change and Message Board is located in the Registration Area on the 2nd Floor Promenade, where any last minute changes to the Program will be posted. CANCELLATION OF THE CONGRESS In the unlikely event that the 2nd World Congress on Interventional Therapies for Type 2 Diabetes is abbreviated or cancelled for any reason whatsoever, the Weill Cornell Medical College, the NewYork-Presbyterian Hospital and the Giovanni Lorenzini Medical Foundation and Fondazione Giovanni Lorenzini reserve the right, in their sole discretion, to unilaterally terminate the Congress. In such case, the registrant and/or any funding/supporting organization hereby agrees to waive any claim against the Weill Cornell Medical College, the NewYork- Presbyterian Hospital and the Giovanni Lorenzini Medical Foundation and Fondazione Giovanni Lorenzini, for damages or compensation including but not limited to, fees for registration, housing, airfare, and incidental charges. 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 7

Congress Advisory Committee CONGRESS DIRECTOR Francesco Rubino, MD Chief, GI Metabolic Surgery Director, Diabetes Surgery Center Weill Cornell Medical College NewYork-Presbyterian Hospital New York, NY USA M. Sue Kirkman, MD Senior Vice President, Medical Affairs and Community Information American Diabetes Association Alexandria, VA USA Linda Cann, MSEd Managing Director, Professional Education, Conventions and International Affairs American Diabetes Association Alexandria, VA USA Ricardo V. Cohen, MD Co-Director The Center for the Surgical Treatment of Morbid Obesity & Metabolic Disorder Alemão Oswaldo Cruz Hospital São Paulo, Brazil Harold E. Lebovitz, MD Professor, Medicine SUNY Health Science Center at Brooklyn Brooklyn, NY USA Fabrizio Michelassi, MD Lewis Atterbury Stinson Professor and Chairman Department of Surgery Weill Cornell Medical College Surgeon-in-Chief NewYork-Presbyterian Hospital/Weill Cornell Medical Center New York, NY USA David E. Cummings, MD Professor, Medicine Metabolism, Endocrinology & Nutrition Deputy Director, Diabetes Endocrinology Research Center University of Washington School of Medicine Seattle, WA USA Alfons Pomp, MD, FRCSC, FACS Leon C. Hirsch Professor of Surgery Chief, Section Laparoscopic & Bariatric Surgery Weill Cornell Medical College New York, NY USA Antonio M. Gotto, Jr., MD, DPhil The Stephen and Suzanne Weiss Dean Professor, Medicine Provost, Medical Affairs Weill Cornell Medical College New York, NY USA Philip Schauer, MD Professor, Surgery Lerner College of Medicine Director, Advanced Laparoscopic & Bariatric Surgery Cleveland Clinic Cleveland, OH USA Lee M. Kaplan, MD, PhD Professor, Medicine Harvard Medical School Director, MGH Weight Center Massachusetts General Hospital Boston, MA USA Paul Zimmet, MD, PhD Director Emeritus Director International Research Baker IDI Heart and Diabetes Institute Melbourne, Australia 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 9

Program Committee CONGRESS DIRECTOR Francesco Rubino, MD Chief, GI Metabolic Surgery Director, Diabetes Surgery Center Weill Cornell Medical College NewYork-Presbyterian Hospital New York, NY USA CLINICAL TRACK CHAIR Harold E. Lebovitz, MD Professor, Medicine SUNY Health Science Center at Brooklyn Brooklyn, NY USA CO-CHAIR Phillip Schauer, MD Professor, Surgery Lerner College of Medicine Director, Advanced Laparoscopic & Bariatric Surgery Cleveland Clinic Cleveland, OH USA RESEARCH TRACK CHAIR David E. Cummings, MD Professor, Medicine Metabolism, Endocrinology & Nutrition Deputy Director, Diabetes Endocrinology Research Center University of Washington School of Medicine Seattle, WA USA CO-CHAIR Lee Kaplan, MD, PhD Professor, Medicine Harvard Medical School Director, MGH Weight Center Massachusetts General Hospital Boston, MA USA POLICY TRACK CHAIR Paul Zimmet, MD, PhD Director Emeritus Director International Research Baker IDI Heart and Diabetes Institute Melbourne, Australia CO-CHAIR David R. Flum, MD, MPH Professor, Surgery Associate Chair, Research University of Washington Seattle, WA USA 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 11

Program Committee Domenico Accili, MD Professor, Medicine Director, Diabetes and Endocrinology Research Center Columbia University New York, NY USA Allison B. Goldfine, MD Associate Professor, Medicine Harvard Medical School Section Head, Clinical Research Joslin Diabetes Center Boston, MA USA Louis J. Aronne, MD, FACP Clinical Professor, Medicine Director, Comprehensive Weight Control Program Weill Cornell Medical College New York, NY USA M. Sue Kirkman, MD Senior Vice President, Medical Affairs and Community Information American Diabetes Association Alexandria, VA USA Ricardo V. Cohen, MD Co-Director The Center for the Surgical Treatment of Morbid Obesity & Metabolic Disorder Alemão Oswaldo Cruz Hospital São Paulo, Brazil Samuel Klein, MD William H. Danforth Professor of Medicine and Nutritional Science Washington University School of Medicine St. Louis, MO USA John B. Dixon, MBBS, PhD, FRACGP, FRCPEdin NHMRC Senior Research Fellow, Vascular and Hypertension-Obesity Research Baker IDI Heart and Diabetes Institute Melbourne, Australia Rudolph L. Leibel, MD Christopher J. Murphy Memorial Professor of Diabetes Research Co-Director, Naomi Berrie Diabetes Center; Head, Division of Molecular Genetics Columbia University Medical Center New York, NY USA Robin S. Goland, MD Professor of Clinical Medicine and Pediatrics Columbia University College of Physicians & Surgeons New York, NY USA Carel W. Le Roux, MB, ChB Reader, Investigative Science Department of Medicine Imperial College London, UK 12 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org

Program Committee Timothy E. McGraw, PhD Professor, Biochemistry Weill Cornell Medical College New York, NY USA Jesse Roth, MD, FACP Professor, Medicine Albert Einstein College of Medicine Investigator, Feinstein Institute for Medical Research Manhasset, NY USA Jeffrey I. Mechanick, MD Clinical Professor, Medicine Endocrinology, Diabetes and Bone Disease Director, Metabolic Support Mount Sinai School of Medicine New York, NY USA Bruce Wolfe, MD Professor, Surgery Oregon Health & Science University Portland, OR USA 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 13

Distinguished Faculty Domenico Accili, MD Professor, Medicine Director, Diabetes & Endocrinology Research Center Columbia University New York, NY USA Louis J. Aronne, MD, FACP Clinical Professor, Medicine Director, Comprehensive Weight Control Program Weill Cornell Medical College New York, NY USA Ted D. Adams, PhD, MPH Program Director, Cardiovascular Genetics, University of Utah and Health Fitness Institute LDS Hospital, Intermountain Healthcare Salt Lake City, UT USA Nicola Basso, MD, FACS Professor, Surgery Paride Stefanini Department of Surgery Sapienza University of Rome Azienda Policlinico Umberto I Rome, Italy Sir K. George Alberti, MA, DPhil, BM BCh Senior Research Investigator, Medicine Imperial College London, UK Richard N. Bergman, PhD Keck Professor of Medicine Chair, Department of Physiology and Biophysics Keck School of Medicine University of Southern California Los Angeles, CA USA Stephanie A. Amiel, MD RD Lawrence Professor, Diabetic Medicine King s College London, UK Zachary T. Bloomgarden, MD Clinical Professor, Medicine, Endocrinology, Diabetes, & Bone Disease Mount Sinai School of Medicine New York, NY USA Caroline M. Apovian, MD Professor, Medicine Boston University School of Medicine Director, Nutrition and Weight Management Boston Medical Center Boston, MA USA Stacy A. Brethauer, MD Associate Staff Surgeon Laparoscopic & Bariatric Surgery Cleveland Clinic Cleveland, OH USA 14 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org

Distinguished Faculty Michael S. Brown, MD W.A. (Monty) Moncrief Distinguished Chair, Cholesterol & Arteriosclerosis Research Regental Professor, Molecular Genetics The University of Texas Southwestern Medical Center Dallas, TX USA 1985 Nobel Laureate for Medicine or Physiology Tamara Darsow, PhD Vice President Research Programs American Diabetes Association Alexandria, VA USA Henry Buchwald, MD, PhD Professor, Surgery and Biomedical Engineering University of Minnesota Minneapolis, MN USA Professor the Lord Ara Darzi of Denham, PC KBE HonFREng FmedSci Professor, Surgery Imperial College London London, UK Pradeep Chowbey, MD, FACS Chair, Minimal Access Surgery Joint Managing Director, Max Institute of Minimal Access, Metabolic & Bariatric Surgery New Delhi, India Aureo Ludovico De Paula, MD Director, Surgery Specialty Hospital Goias, Brazil Ricardo V. Cohen, MD Co-Director The Center for the Surgical Treatment of Morbid Obesity and Metabolic Disorder Alemão Oswaldo Cruz Hospital São Paulo, Brazil Ralph DeFronzo, MD Professor, Medicine Chief, Diabetes Division University of Texas Health Science Center San Antonio, TX USA David E. Cummings, MD Professor, Medicine Metabolism, Endocrinology & Nutrition Deputy Director, Diabetes Endocrinology Research Center University of Washington School of Medicine Seattle, WA USA Stefano Del Prato, MD Professor, Endocrinology and Metabolism Chief, Section of Diabetes University of Pisa Cisanello Hospital Pisa, Italy 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 15

Distinguished Faculty John B. Dixon, MBBS, PhD, FRACGP, FRCPEdin NHMRC Senior Research Fellow, Vascular and Hypertension-Obesity Research Baker IDI Heart and Diabetes Institute Melbourne, Australia Michel Gagner, MD Clinical Professor, Surgery Clinique Michel Gagner MD, Inc. Montreal, QC Canada Robert H. Eckel, MD Professor, Medicine Professor, Physiology and Biophysics University of Colorado - Anshutz Medical Campus Aurora, CO USA Manoel Galvao Neto, MD Surgeon & Gastroenterologist Scientific Coordinator Gastro Obeso Center São Paulo, Brazil Ele Ferrannini, MD Professor, Internal Medicine University of Pisa Pisa, Italy Allison B. Goldfine, MD Associate Professor, Medicine Harvard Medical School Section Head, Clinical Research Joslin Diabetes Center Boston, MA USA David R. Flum, MD, MPH Professor, Surgery Associate Chair, Research University of Washington Seattle, WA USA Joseph L. Goldstein, MD Julie and Louis A. Beecherl Distinguished Chair in Biomedical Science Regental Professor, Molecular Genetics The University of Texas Southwestern Medical Center Dallas, TX USA 1985 Nobel Laureate for Medicine or Physiology John Funder, MD, PhD, FRACP, FRCP Professor, Medicine Prince Henry's Institute Clayton, Australia Antonio M. Gotto, Jr., MD, DPhil The Stephen and Suzanne Weiss Dean Professor, Medicine Provost, Medical Affairs Weill Cornell Medical College New York, NY USA 16 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org

Distinguished Faculty Jan Willem M. Greve, MD, PhD Professor, Surgery Chair, Department of Surgery Atrium Medical Center Parkstad Heerleen, Limburg The Netherlands Shashank R. Joshi, MBBS, MD, DM Professor, Consultant Grant Medical College and Sir JJ Group of Hospitals Mumbai, India Peter Hill, MD, PhD Corporate Medical Director Medical Administration Department Hamad Medical Corporation Doha, Qatar Steven H. Kahn, MB, ChB Professor, Medicine VA Puget Sound Health Care System University of Washington Seattle, WA USA Bjorn Hofmann, MSc, PhD Professor, Medical Ethics Institute for Health and Society University of Oslo Oslo, Norway Lee Kaplan, MD, PhD Professor, Medicine Harvard Medical School Director, MGH Weight Center Massachusetts General Hospital Boston, MA USA Jens Juul Holst, MD Professor, Medical Physiology Institute of Biomedical Sciences Copenhagen, Denmark Catherine Keating, MPH Senior Research Fellow Deakin Health Economics, Faculty of Health Deakin University Melbourne, Australia Linong Ji, MD Co-Director, Peking University Diabetes Center Director, Department Of Endocrinology And Metabolism, Peking University People s Hospital President, Chinese Diabetes Society Vice President, Chinese Endocrinologist Association Beijing, China M. Sue Kirkman, MD Senior Vice President, Medical Affairs and Community Information American Diabetes Association Alexandria, VA USA 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 17

Distinguished Faculty Samuel Klein, MD William H. Danforth Professor of Medicine and Nutritional Science Washington University School of Medicine St Louis, MO USA Carel W. Le Roux, MD, PhD Reader, Investigative Science Department of Medicine Imperial College London, UK Judith Korner, MD, PhD Associate Professor, Medicine Director, Weight Control Center Columbia University Medical Center New York, NY USA Harold E. Lebovitz, MD Professor, Medicine SUNY Health Science Center at Brooklyn Brooklyn, NY USA Blandine B. Laferrere, MD Associate Professor, Medicine Columbia University College of Physicians and Surgeons New York, NY USA Frank Lefevre, MD Associate Professor, Medicine Senior Scientist, BCBSA Technology Evaluation Center Northwestern Feinberg School of Medicine Chicago, IL USA Muffazal Abdulkader Lakdawala, MD Chief, Minimal Access & Bariatric Surgery Department Centre for Obesity and Diabetes Support Saifee Hospital Mumbai, India Rudolph L. Leibel, MD Christopher J. Murphy Memorial Professor of Diabetes Research Co-Director, Naomi Berrie Diabetes Center Head, Division of Molecular Genetics Columbia University Medical Center New York, NY USA David Lautz, MD Director of Bariatric Surgery Harvard Medical School, Brigham and Women's Hospital Boston, MA USA Ruth E. Ley, PhD Assistant Professor, Microbiology Cornell University Ithaca, NY USA 18 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org

Distinguished Faculty Rui Li, PhD Health Economist Centers for Disease Control and Prevention Atlanta, GA USA Xavier Pi-Sunyer, MD Chief of Endocrinology and Professor of Medicine St. Luke s Roosevelt Hospital Columbia University New York, NY USA Timothy E. McGraw, PhD Professor, Biochemistry Weill Cornell Medical College New York, NY USA Alfons Pomp, MD, FRCSC, FACS Leon C. Hirsch Professor of Surgery Chief, Section Laparoscopic & Bariatric Surgery Weill Cornell Medical College New York, NY USA Jeffrey I. Mechanick, MD Clinical Professor, Medicine, Endocrinology, Diabetes and Bone Disease Director, Metabolic Support Mount Sinai School of Medicine New York, NY USA Walter J. Pories, MD, FACS Professor, Surgery, Biochemistry and Exercise and Sports Science East Carolina University Greenville, NC USA Geltrude Mingrone, MD, PhD Professor, Internal Medicine, Endocrinology Catholic University of the Sacred Heart Rome, Italy Jesse Roth, MD, FACP Professor, Medicine Albert Einstein College of Medicine Investigator, Feinstein Institute for Medical Research Manhasset, NY USA John J. Moore, DO, FAAFP Patient Management Medical Director for the Northeast Region AETNA Blue Bell, PA USA Francesco Rubino, MD Chief, GI Metabolic Surgery Director, Diabetes Surgery Center Weill Cornell Medical College NewYork-Presbyterian Hospital New York, NY USA 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 19

Distinguished Faculty Mohammed Fathy Saoud, PhD President Qatar Foundation Doha, Qatar Lars V. Sjöström, MD, PhD Professor Emeritus, SOS Secretariate Internal Medicine Sahlgrenska University Hospital Göteborg, Sweden Phillip Schauer, MD Professor, Surgery Lerner College of Medicine Director, Advanced Laparoscopic & Bariatric Surgery Cleveland Clinic Cleveland, OH USA Myrlene Staten, MD Senior Advisor, Diabetes Translational Research NIDDK, National Institutes of Health Bethesda, MD USA Gary Schwartz, PhD Professor of Medicine & Neuroscience Albert Einstein College of Medicine of Yeshiva University Bronx, NY USA Harvey J. Sugerman, MD Emeritus Professor, Surgery Editor-in-Chief, Surgery for Obesity and Related Diseases Virginia Commonwealth University Richmond, VA USA Randy J. Seeley, PhD Director, Cincinnati Diabetes Obesity Center University of Cincinnati Donald C. Harrison Endowed Professor in Medicine Metabolic Diseases Institute Cincinnati, OH USA Sean D. Sullivan, PhD Professor, Health Sciences and Department of Pharmacy Associate Dean for Research University of Washington School of Pharmacy Seattle, WA USA Gerald I. Shulman, MD, PhD Investigator, Howard Hughes Medical Institute Professor, Physiological Chemistry, Medicine (Endocrinology) and Cellular & Molecular Physiology Associate Director, Diabetes-Endocrinology Research Center Associate Director, Medical Scientist Training Program Yale University School of Medicine New Haven, CT USA Tess Van Der Merwe, MBChB, PhD Director Centres of Excellence for Metabolic Medicine and Surgery Gauteng, South Africa 20 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org

Distinguished Faculty Bruce Wolfe, MD, FACS Professor, Surgery Oregon Health & Science University Portland, OR USA Paul Zimmet, MD, PhD Director Emeritus Director International Research Baker IDI Heart and Diabetes Institute Melbourne, Australia Carol H. Wysham, MD Clinical Associate Professor, Medicine University of Washington School of Medicine Section Head, Rockwood Center for Diabetes & Endocrinology Rockwood Clinic Spokane, WA USA Mahmoud Ali Zirie, MD Professor, Medicine Head, Endocrinology Diabetes Division Hamad Medical Corporation Doha, Qatar James Young, MD Professor, Medicine Executive Dean Lerner College of Medicine Institute Chair Endocrinology & Metabolism Institute Cleveland Clinic Cleveland, OH USA 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 21

Guest Experts In addition to contributing to the scholarship of the audience, the presence of Guest Experts is meant to facilitate a lively discussion and debate throughout the course of the World Congress. Guest Experts will also steer group discussion during breakout sessions on Tuesday, March 29th. We would like to thank the following individuals for providing a unique perspective to the emerging field of interventional diabetology: Vince Aguirre, MD............................... USA Luiz Vicente Berti, MD............................ Brazil Morris J. Birnbaum, MD, PhD....................... USA Robin Blackstone, MD, FACS....................... USA Camilo Boza, MD, FACS.......................... Chile David J. Brillon, MD.............................. USA Marco Castagneto, MD............................ Italy Lee-Ming Chuang, MD, PhD....................... Taiwan Gregory F. Dakin, MD............................. USA Alex Escalona, MD............................... Chile Mathias A. Fobi, MD, FACS, FASMBS, FICS, FACN....... USA Paolo Gentileschi, MD............................. Italy Giovanni Ghirlanda, MD............................ Italy Ramen Goel, MD................................ India Neil E. Hutcher, MD, FACS......................... USA William B. Inabnet, III, MD, FACS..................... USA Kazunori Kasama, MD, FACS...................... Japan Subhash Kini, MD, FRCS, FACS..................... USA John G. Kral, MD, PhD, FACS....................... USA Wei-Jei Lee, MD, PhD........................... Taiwan Bassem M. Masri, MD............................ USA Francois Pattou, MD............................ France Antonio E. Pontiroli, MD............................ Italy Almino Ramos, MD.............................. Brazil Mitch Roslin, MD, FACS........................... USA Naina Sinha, MD................................ USA April D. Strader, PhD.............................. USA Richard Stubbs, MD, FRCS, FRACS............ New Zealand Michel Suter, MD........................... Switzerland Julio Teixeira, MD, FACS........................... USA Antonio José Torres, MD, PhD...................... Spain Jonathan A. Waitman, MD......................... USA 22 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org

Program At-A-Glance MONDAY, MARCH 28, 2011 7:00 am - 8:00 am Continental Breakfast (Rhinelander Gallery) 7:00 am - 9:00 pm 7:00 am - 6:45 pm 8:00 am - 8:20 am 8:20 am - 8:35 am Registration Open (2nd Floor Promenade) Exhibits and Posters (Rhinelander Gallery) Opening Ceremony (Grand Ballroom) Introduction of the World Congress: Scope and Methods F. Rubino (New York, NY USA) CLINICAL TRACK SESSION I 8:35 am - 10:50 am (Grand Ballroom) Clinical Outcomes of Conventional and Surgical Treatments for T2DM 10:50 am - 11:10 am Refreshment Break (Grand Ballroom Foyer) POLICY TRACK SESSION I (Grand Ballroom) 11:10 am - 12:30 pm The International Diabetes Federation (IDF) Position Statement on Interventional Treatments of Type 2 Diabetes 12:30 pm - 1:30 pm Lunch (Rhinelander Gallery) CLINICAL TRACK SESSION II (Grand Ballroom) 1:30 pm - 3:00 pm CV Risk Reduction and Survival in Patients with Diabetes: Medical versus Surgical Therapy 3:00 pm - 3:20 pm Refreshment Break (Grand Ballroom Foyer) CLINICAL TRACK SESSION III (Grand Ballroom) 3:20 pm - 5:45 pm Diabetes Surgery: Indications, Choice of Procedure & Peri-Operative Management 5:45 pm - 6:45 pm 8:00 pm - 11:00 pm Poster Session (Rhinelander Gallery) Welcome Reception (Trianon Ballroom) TUESDAY, MARCH 29, 2011 6:30 am - 7:30 am Continental Breakfast (Rhinelander Gallery) 6:30 am - 7:00 pm 6:30 am - 3:00 pm Registration Open (2nd Floor Promenade) Exhibits and Posters (Rhinelander Gallery) RESEARCH TRACK SESSION I (Grand Ballroom) 7:30 am - 9:40 am Mechanisms of Action of Surgery RESEARCH TRACK SESSION II (Grand Ballroom) 9:40 am - 11:10 am Novel Experimental Approaches for Diabetes/Obesity 11:10 am - 11:30 am Refreshment Break (Grand Ballroom Foyer) 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 23

TUESDAY, MARCH 29, 2011 (cont d) RESEARCH TRACK SESSION III (Grand Ballroom) 11:30 am - 1:00 pm Defining Priorities for Clinical Research in Metabolic/Diabetes Surgery 1:00 pm - 2:00 pm Lunch (Rhinelander Gallery) POLICY TRACK SESSION II (Grand Ballroom) 2:00 pm - 3:00 pm Global Burden of Diabetes and Resource Availability for Interventional Approaches POLICY TRACK SESSION III (Grand Ballroom) 3:00 pm - 4:30 pm Cost Effectiveness of Diabetes Surgery: Implications for Public and Private Health Insurance 4:30 pm - 4:50 pm Refreshment Break (Grand Ballroom Foyer) BREAKOUT SESSIONS AND WORKSHOPS (Sutton Complex Rooms) 4:50 pm - 6:50 pm Breakout Sessions Clinical (Sutton North/Beekman) Research (Sutton Center) Policy (Sutton South/Regent) WEDNESDAY, MARCH 30, 2011 7:00 am - 2:00 pm 7:00 am - 8:00 am Registration Open (2nd Floor Promenade) Continental Breakfast (Grand Ballroom Lobby) KEYNOTE LECTURE (Grand Ballroom) 8:00 am - 9:00 am Surviving Starvation: Essential Role of the Ghrelin-Growth Hormone Axis M.S. Brown (Dallas, TX USA) J.L. Goldstein (Dallas, TX USA) RESEARCH TRACK SESSION IV (Grand Ballroom) 9:00 am - 10:40 am The Role of the Gut in the Physiology and Pathophysiology of Obesity and Diabetes 10:40 am - 11:00 am PANEL DISCUSSION 11:00 am - 12:00 pm Refreshment Break (Grand Ballroom Foyer) (Grand Ballroom) The GI tract: Could it be the missing link between obesity and diabetes? EXECUTIVE SUMMARIES/TAKE HOME MESSAGE (Grand Ballroom) 12:00 pm - 1:15 pm Presentation of Executive Summaries and Conclusions 1:20 pm World Congress Adjourns 24 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org

Scientific Program MONDAY, MARCH 28, 2011 7:00 am - 8:00 am CONTINENTAL BREAKFAST (Rhinelander Gallery) 8:00 am - 8:20 am Grand Ballroom 8:20 am - 8:35 am Grand Ballroom Opening Ceremony Introduction of the World Congress: Scope and Methods F. Rubino (New York, NY USA) CLINICAL TRACK SESSION I 8:35 am - 10:50 am Grand Ballroom Clinical Outcomes of Conventional and Surgical Treatments for T2DM Chairs: W. Pories (Greenville, NC USA) H.E. Lebovitz (Brooklyn, NY USA) 8:35 am - 8:55 am 8:55 am - 9:15 am 9:15 am - 9:30 am 9:30 am - 9:45 am 9:45 am - 10:00 am 10:00 am - 10:50 am 10:50 am - 11:10 am Glycemic and metabolic control with current pharmacologic treatments S. Del Prato (Pisa, Italy) Glycemic and metabolic outcomes with bariatric/metabolic surgery: overview P. Schauer (Cleveland, OH USA) Long-term prevention and remission of diabetes after bariatric surgery in the SOS study L. Sjöström (Göteborg, Sweden) Safety profiles of pharmaceutical approaches H.E. Lebovitz (Brooklyn, NY USA) Safety profiles of surgical approaches: short and long term B.M. Wolfe (Portland, OR USA) Panel Discussion Panelists: S.A. Amiel (London, UK), Z.T. Bloomgarden (New York, NY USA), J. Dixon (Melbourne, Australia), A. Pomp (New York, NY USA), H. Buchwald (Minneapolis, MN USA), A.B. Goldfine (Boston, MA USA), K.G. Alberti (London, UK), J.I. Mechanick (New York, NY USA), X. Pi-Sunyer (New York, NY USA) COFFEE BREAK (Grand Ballroom Foyer) POLICY TRACK SESSION I 11:10 am - 12:30 pm Grand Ballroom The International Diabetes Federation (IDF) Position Statement on Interventional Treatments of Type 2 Diabetes Chairs: J. Dixon (Melbourne, Australia) K.G. Alberti (London, UK) 11:10 am - 11:20 am 11:20 am - 11:40 am 11:40 am - 12.30 pm Existing guidelines for surgical treatment of obesity and diabetes (NIH, DSS, ADA) L.M. Kaplan (Boston, MA USA) The IDF position statement on interventional therapies for type 2 diabetes P. Zimmet (Melbourne, Australia) Panel Discussion Panelists: C. Wysham (ADA) (Seattle, WA USA), J.I. Mechanick (AACE) (New York, NY USA), S.A. Amiel (Diabetes UK) (London, UK), X. Pi-Sunyer (NHLBI) (New York, NY USA), A.M. Gotto (New York, NY USA), F. Rubino (New York, NY USA), R.H. Eckel (Aurora, CO USA) 12:30 pm - 1:30 pm LUNCH BREAK (Rhinelander Gallery) 26 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org

Scientific Program CLINICAL TRACK SESSION II 1:30 pm - 3:00 pm Grand Ballroom CV Risk Reduction and Survival in Patients with Diabetes: Medical versus Surgical Therapy Chairs: A.M. Gotto (New York, NY USA) K.G. Alberti (London, UK) 1:30 pm - 1:50 pm 1:50 pm - 2:05 pm 2:05 pm - 2:15 pm 2:15 pm - 3:00 pm 3:00 pm - 3:20 pm CV risk, CVD and diabetes-related mortality: impact of pharmacologic approaches R.H. Eckel (Aurora, CO USA) Long-term (20 years) impact of bariatric surgery on CV risk and CVD: an update from the SOS study L. Sjöström (Göteborg, Sweden) The impact of bariatric/metabolic surgery on CV risk and long-term survival T.D. Adams (Salt Lake City, UT USA) Panel Discussion Panelists: R. DeFronzo (San Antonio, TX USA), E. Ferrannini (Pisa, Italy), S.R. Joshi (Mumbai, India), S.E. Kahn (Seattle, WA USA), J. Young (Cleveland, OH USA), H.J. Sugerman (Richmond, VA USA), W. Pories (Greenville, NC USA) COFFEE BREAK (Grand Ballroom Foyer) CLINICAL TRACK SESSION III 3:20 pm - 5:45 pm Grand Ballroom Diabetes Surgery: Indications, Choice of Procedure & Peri-Operative Management Chairs: L. Aronne (New York, NY USA) J. Young (Cleveland, OH USA) 3:20 pm - 3:35 pm 3:35 pm - 3:50 pm 3:50 pm - 4:05 pm 4:05 pm - 4:40 pm 4:40 pm - 4:55 pm 4:55 pm - 5:15 pm 5:15 pm - 5:45 pm Predicting factors of diabetes control/reasonable criteria for surgical indication J. Korner (New York, NY USA) Preoperative management of diabetic patients C.M. Apovian (Boston, MA USA) Which surgical procedure is best? Summary of available evidence from comparative clinical studies in high and low BMI patients H.J. Sugerman (Richmond, VA USA) Panel Discussion Panelists: H.E. Lebovitz (Brooklyn, NY USA), S.R. Joshi (Mumbai, India), J.I. Mechanick (New York, NY USA), J. Dixon (Melbourne, Australia), M. Gagner (Montreal, QC, Canada), R.V. Cohen (São Paulo, Brazil) Postoperative management of obese and diabetic patients; the role of integrated/multimodality therapies L. Aronne (New York, NY USA) A rational and physiologic approach to the management of diabetes after surgery R. DeFronzo (San Antonio, TX USA) Panel Discussion Panelists: C. Wysham (Seattle, WA USA), S.E. Kahn (Seattle, WA USA), R.N. Bergman (Los Angeles, CA USA), L. Ji (Beijing, China), S. Del Prato (Pisa, Italy) 5:45 pm - 6:45 pm 8:00 pm POSTER SESSION (Rhinelander Gallery) WELCOME RECEPTION (Trianon Ballroom) 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 27

Scientific Program TUESDAY, MARCH 29, 2011 6:30 am - 7:30 am CONTINENTAL BREAKFAST (Rhinelander Gallery) RESEARCH TRACK SESSION I 7:30 am - 9:40 am Grand Ballroom Mechanisms of Action of Surgery Chairs: L.M. Kaplan (Boston, MA USA) S.E. Kahn (Seattle, WA USA) 7:30 am - 7:45 am 7:45 am - 8:00 am 8:00 am - 8:15 am 8:15 am - 8:30 am 8:30 am - 9:00 am 8:30 am - 8:45 am 8:45 am - 9:00 am 9:00 am - 9:40 am Mechanisms of Weight Loss: beyond restriction and malabsorption R.J. Seeley (Cincinnati, OH USA) Effect of GI surgery on insulin secretion/sensitivity S. Klein (St. Louis, MO USA) Effects of GI surgery on food choices and energy expenditure C.W. Le Roux (London, UK) Effects of GI surgery on glucose homeostasis J.J. Holst (Copenhagen, Denmark) Debate: Diabetes control by GI surgery is explained by weight-independent mechanisms Yes: D.E. Cummings (Seattle, WA USA) No: E. Ferrannini (Pisa, Italy) Panel Discussion: Weight independent mechanisms of diabetes control: weighing the evidence Panelists: J. Korner (New York, NY USA), G. Mingrone (Rome, Italy), R.N. Bergman (Los Angeles, CA USA), R. DeFronzo (San Antonio, TX USA), B.B. Laferrere (New York, NY USA), G.J. Schwartz (New York, NY USA) RESEARCH TRACK SESSION II 9:40 am - 11:10 am Grand Ballroom Novel Experimental Approaches for Diabetes/Obesity Chairs: H. Buchwald (Minneapolis, MN USA) S. Klein (St. Louis, MO USA) 9:40 am - 9:55 am 9:55 am - 10:10 am 10:10 am - 10:25 am 10:25 am - 10:40 am 10:40 am - 11:10 am Novel GI surgical procedures (DJB and Ileal Interposition: alone and with associated sleeve gastrectomy) R.V. Cohen (São Paulo, Brazil) Endoluminal procedures for obesity/diabetes S.A. Brethauer (Cleveland, OH USA) Endoluminal devices for obesity/diabetes L.M. Kaplan (Boston, MA USA) Pacing/GI electric stimulation for diabetes H.E. Lebovitz (Brooklyn, NY USA) Panel Discussion Panelists: J.W.M. Greve (Heerleen, Netherlands), M. Galvao Neto (São Paulo, Brazil), A. De Paula (Goiania, Brazil), W. Pories (Greenville, NC USA), J. Funder (Clayton, Australia), S.R. Joshi (Mumbai, India) 11:10 am - 11:30 am COFFEE BREAK (Grand Ballroom Lobby) 28 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org

Scientific Program RESEARCH TRACK SESSION III 11:30 am - 1:00 pm Grand Ballroom Defining Priorities for Clinical Research in Metabolic/Diabetes Surgery Chairs: A.B. Goldfine (Boston, MA USA) J. Roth (Manhasset, NY USA) 11:30 am - 11:45 am 11:45 am - 12:00 pm 12:00 pm - 12:15 pm 12:15 pm - 1:00 pm 1:00 pm - 2:00 pm Clinical trials in diabetes surgery: overview of ongoing trials; challenges for study design, practical issues in surgical trials A.B. Goldfine (Boston, MA USA) Clinical trials in diabetes surgery: ethical aspects B.M. Hofmann (Oslo, Norway) Advantages and disadvantages of each design, multisite vs consortium model for large clinical trials F. Rubino (New York, NY USA) Panel Discussion: Priorities for clinical research in diabetes surgery; costs/funding, ethical aspects Panelists: P. Schauer (Cleveland, OH USA), R. DeFronzo (San Antonio, TX USA), J. Korner (New York, NY USA), D. Lautz (Boston, MA USA), M. Staten (Bethesda, MD USA), F. Saoud (Doha, Qatar), T. Darsow (Alexandria, VA USA) LUNCH BREAK (Rhinelander Gallery) POLICY TRACK SESSION II 2:00 pm - 3:00 pm Grand Ballroom Global Burden of Diabetes and Resource Availability for Interventional Approaches Chairs: P. Zimmet (Melbourne, Australia) P. Chowbey (New Delhi, India) 2:00 pm - 2:15 pm 2:15 pm - 2:30 pm 2:30 pm - 3:00 pm The global epidemiology of diabetes P. Zimmet (Melbourne, Australia) The global costs of diabetes R. Li (Atlanta, GA USA) Panel Discussion: Specific regional challenges for diabetes prevention and treatment Panelists: L. Ji (Beijing, China), J. Funder (Clayton, Australia), T. Van Der Merwe (Pretoria, South Africa), A. Darzi (London, UK), M. Ali Zirie (Doha, Qatar), R. Li (Atlanta, GA USA) POLICY TRACK SESSION III 3:00 pm - 4:30 pm Grand Ballroom Cost Effectiveness of Diabetes Surgery: Implications for Public and Private Health Insurance Chairs: A. Darzi (London, UK) D. Flum (Seattle, WA USA) 3:00 pm - 3:15 pm 3:15 pm - 3:30 pm 3:30 pm - 3:45 pm 3:45 pm - 4:30 pm Review of what we know about cost-effectiveness of bariatric surgery with special regard to patients with diabetes C. Keating (Burwood, Australia) How governments consider evidence on cost-effectiveness S.D. Sullivan (Seattle, WA USA) How payers consider the evidence of cost and effectiveness F. Lefevre (Chicago, IL USA) Panel Discussion: Simply cost-effective? Reconciling cost-evaluations related to diabetes interventions Panelists: R. Li (Atlanta, GA USA), C. Keating (Burwood, Australia), S.D. Sullivan (Seattle, WA USA), F. Lefevre (Chicago, IL USA), J.J. Moore (Blue Bell, PA USA) 4:30 pm - 4:50 pm COFFEE BREAK (Grand Ballroom Foyer) 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 29

Scientific Program TUESDAY, MARCH 29, 2011 (continued) BREAKOUT SESSIONS AND WORKSHOPS 4:50 pm - 6:50 pm Breakout Sessions for Interactive Discussion and Preparation of Executive Summary CLINICAL TRACK 4:50 pm - 6:50 pm Sutton North/Beekman Defining appropriate surgical candidates and good clinical practice for perioperative management and post-operative follow-up Chairs: H.E. Lebovitz (Brooklyn, NY USA) P. Schauer (Cleveland, OH USA) 4:50 pm - 5:25 pm 4:50 pm - 4:55 pm 4:55 pm - 5:10 pm 5:10 pm - 5:25 pm Workshop A: Defining appropriate surgical candidates for diabetes surgery Who should be referred for surgical treatment of diabetes? H.E. Lebovitz (Brooklyn, NY USA) Expert Panel Comments W.J. Pories (Greenville, NC USA), L.J. Aronne (New York, NY USA), R. DeFronzo (San Antonio, TX USA), J. Young (Cleveland, OH USA) Q&A: Guest Experts and Audience Interactive Opinion Polls 5:25 pm - 6:20 pm 5:25 pm - 5:50 pm 5:50 pm - 6:05 pm 6:05 pm - 6:20 pm Workshop B: Defining ideal indications for each surgical procedure Which patients should undergo... Biliopancreatic Diversion/DS - A. Pomp (New York, NY USA) Sleeve Gastectomy - M. Gagner (Montreal, QC, Canada) Gastric Bypass - P. Schauer (Cleveland, OH USA) Gastric Banding - J.B. Dixon (Melbourne, Australia) Novel GI Procedures: To re-route or not to re-route the bowel? - R.V. Cohen (São Paulo, Brazil) Expert Panel Comments H. Buchwald (Minneapolis, MN USA), P. Chowbey (New Delhi, India), A.L. De Paula (Goiânia, Brazil), J.W.M. Greve (Heerleen, Netherlands) Q&A: Guest Experts and Audience Interactive Opinion Polls 6:20 pm - 6:50 pm 6:20 pm - 6:25 pm 6:25 pm - 6:40 pm 6:40 pm - 6:50 pm Workshop C: Defining and measuring success of surgical treatment of diabetes Definition of success and appropriate clinical measures to assess outcomes of surgical treatment J.I. Mechanick (New York, NY USA) Expert Panel Comments H.J. Sugerman (Richmond, VA USA), J. Korner (New York, NY USA), R. DeFronzo (San Antonio, TX USA), S.R. Joshi (Mumbai, India) Q&A: Guest Experts and Audience Interactive Opinion Polls 30 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org

Scientific Program BREAKOUT SESSIONS AND WORKSHOPS 4:50 pm - 6:50 pm Breakout Sessions for Interactive Discussion and Preparation of Executive Summary RESEARCH TRACK 4:50 pm - 6:50 pm Sutton Center Defining priorities for clinical trials and investigations on mechanisms of action of surgery Chairs: L. Kaplan (Boston, MA USA) D.E. Cummings (Seattle, WA USA) 4:50 pm - 5:35 pm 4:50 pm - 5:00 pm 5:00 pm - 5:20 pm 5:20 pm - 5:35 pm Workshop A: Defining mechanisms of action of surgery and their implications for future diabetes therapies and understanding of disease mechanisms Mechanisms of action of metabolic surgery: what is clear and what is not Lessons for future pharmacologic therapies Lessons about diabetes/obesity pathophysiology L. Kaplan (Boston, MA USA) Expert Panel Comments G. Mingrone (Rome, Italy), G. Schwartz (Bronx, NY USA), B.B. Laferrere (New York, NY USA), R.N. Bergman (Los Angeles, CA USA) Q&A: Guest Experts and Audience Interactive Opinion Polls 5:35 pm - 6:10 pm 5:35 pm - 5:40 pm 5:40 pm - 5:55 pm 5:55 pm - 6:10 pm Workshop B: Defining appropriate methods of innovation in bariatric and metabolic surgery and novel interventional treatments for diabetes Defining proper clinical and pre-clinical assessment of new surgical procedures and devices C.W. Le Roux (London, UK) Expert Panel Comments B.M. Hofmann (Oslo, Norway), M.Galvao Neto (São Paulo, Brazil), S. Klein (St. Louis, MO USA), S. Del Prato (Pisa, Italy) Q&A: Guest Experts and Audience Interactive Opinion Polls 6:10 pm - 6:50 pm 6:10 pm - 6:15 pm 6:15 pm - 6:35 pm 6:35 pm - 6:50 pm Workshop C: Defining priorities for clinical research Diabetes surgery: the most compelling clinical issues that require priority testing by randomized clinical trials D.E. Cummings (Seattle, WA USA) Expert Panel Comments A.B. Goldfine (Boston, MA USA), M. Staten (Bethesda, MD USA), S.H. Kahn (Seattle, WA USA), X. Pi-Sunyer (New York, NY USA), D. Lautz (Boston, MA USA) Q&A: Guest Experts and Audience Interactive Opinion Polls 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 31

Scientific Program TUESDAY, MARCH 29, 2011 (continued) BREAKOUT SESSIONS AND WORKSHOPS 4:50 pm - 6:50 pm Breakout Sessions for Interactive Discussion and Preparation of Executive Summary POLICY TRACK 4:50 pm - 6:50 pm Sutton South/Regent Proposing practical solutions to improve access to surgery when indicated Chairs: P. Zimmet (Melbourne, Australia) D. Flum (Seattle, WA USA) 4:50 pm - 5:50 pm 5:00 pm - 5:40 pm 5:40 pm - 5:50 pm Workshop A: Creating a pathway to reconcile professional guidelines P. Zimmet (Melbourne, Australia) Panel Discussion/Round Table with official representatives of the following organizations: NHLBI Obesity Guidelines (X. Pi-Sunyer, New York, NY USA), ADA (M.S. Kirkman, Alexandria, VA USA), AACE (J.I. Mechanick, New York, NY USA), ASMBS (B. Wolfe, Portland, OR USA), TOS (C.M. Apovian, Boston, MA USA), SBCBM (R.V. Cohen, São Paulo, Brazil), SICOB (N. Basso, Rome, Italy), IFSO (M. Lakdawala, Mumbai, India) Interactive Opinion Polls 5:50 pm - 6:50 pm 6:00 pm - 6:40 pm 6:40 pm - 6:50 pm Workshop B: Payer perspectives: creating a pathway for policymakers and payers to reconcile approaches D. Flum (Seattle, WA USA) Panel Discussion/Round Table F. Lefevre (Chicago, IL USA), S.D. Sullivan (Seattle, WA USA), J. Funder (Clayton, Australia), L. Ji (Beijing, China), C. Keating (Buswood, Australia), T. Van Der Merwe (Pretoria, South Africa), P. Hill (Doha, Qatar), J.J. Moore (Blue Bell, PA USA) Interactive Opinion Polls 32 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org

Scientific Program WEDNESDAY, MARCH 30, 2011 7:00 am - 8:00 am CONTINENTAL BREAKFAST (Grand Ballroom Foyer) KEYNOTE LECTURE 8:00 am - 9:00 am Grand Ballroom 8:00 am - 9:00 am Surviving Starvation: Essential Role of the Ghrelin-Growth Hormone Axis M.S. Brown (Dallas, TX USA) J.L. Goldstein (Dallas, TX USA) The Nobel Prize in Physiology or Medicine 1985 was awarded jointly to Michael S. Brown and Joseph L. Goldstein for their discoveries concerning the regulation of cholesterol metabolism. RESEARCH TRACK SESSION IV 9:00 am - 10:40 am Grand Ballroom The role of the gut in the physiology and pathophysiology of obesity and diabetes Chairs: T.E. McGraw (New York, NY USA) D. Accili (New York, NY USA) 9:00 am - 9:20 am 9:20 am - 9:40 am 9:40 am - 10:00 am 10:00 am - 10:20 am 10:20 am - 10:40 am Conventional paradigm of the pathophysiology of obesity R.L. Leibel (New York, NY USA) Conventional paradigm of the pathophysiology of diabetes R.N. Bergman (Los Angeles, CA USA) The physiologic role of the gut in energy and glucose homeostasis J.J. Holst (Copenhagen, Denmark) The role of intestinal microbiota in insulin resistance, obesity/diabetes R.E. Ley (Ithaca, NY USA) Impaired GI physiology in individuals with diabetes/obesity D.E. Cummings (Seattle, WA USA) 10:40 am - 11:00 am COFFEE BREAK (Grand Ballroom Foyer) PANEL DISCUSSION 11:00 am - 12:00 pm Grand Ballroom The GI tract: could it be the missing link between obesity and diabetes? 11:00 am - 11:05 am 11:05 pm - 12:00 pm Introduction F. Rubino (New York, NY USA) Panel Discussion M.S. Brown (Dallas, TX USA), J.L. Goldstein (Dallas, TX USA), G. Shulman (New Haven, CT USA), S. Klein (St. Louis, MO USA), R. DeFronzo (San Antonio, TX USA), S.E. Kahn (Seattle, WA USA), J. Roth (Manhasset, NY USA), L.M. Kaplan (Boston, MA USA) 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 33

Scientific Program WEDNESDAY, MARCH 30, 2011 (continued) EXECUTIVE SUMMARIES/TAKE HOME MESSAGE 12:00 pm - 1:15 pm Grand Ballroom Presentation of Executive Summaries and Conclusions Chairs: M. Sue Kirkman (Alexandria, VA USA) W. Pories (Greenville, NC USA) 12:00 pm - 12:12 pm 12:12 pm - 12:24 pm 12:24 pm - 12:36 pm 12:36 pm - 12:48 pm 12:48 pm - 1:00 pm 1:00 pm - 1:15 pm 1:15 pm - 1:20 pm Clinical Practice H.E. Lebovitz (Brooklyn, NY USA) Priorities for Clinical Research D.E. Cummings (Seattle, WA USA) Reconciling Guidelines P. Zimmet (Melbourne, Australia) Public Health Policies D. Flum (Seattle, WA USA) The evolving paradigm of diabetes pathogenesis J. Roth (Manhasset, NY USA) INTERACTIVE OPINION POLLS CLOSING REMARKS 34 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org

A Accili, Domenico........................... Adams, Ted D............................. B Basso, Nicola............................. 32 Bergman, Richard N................... 27, 28, 31, 33 Bloomgarden Zachary T....................... 26 Brethauer, Stacy A.......................... 28 Brown, Michael S........................... 33 Buchwald, Henry...................... 26, 28, 30 C Chowbey, Pradeep....................... 29, 30 Cohen, Ricardo V.................... 27, 28, 30, 32 Cummings, David E.................. 28, 31, 33, 34 D Darsow, Tamara........................... Darzi, Ara................................ E Eckel Robert H.......................... F Ferrannini, Ele.......................... 27, 28 Flum, David R........................ 29, 32, 34 Funder, John........................ 28, 29, 32 H Hill, Peter................................ 32 Hofmann, Bjørn M........................ 29, 31 Holst, Jens Juul......................... 28, 33 K Kahn, Steven H...................... 27,. 28, 31, 33 Kaplan, Lee M...................... 26, 28, 31, 33 Keating, Catherine........................ 29, 32 Kirkman, M. Sue......................... 32, 34 Klein Samuel......................... 28, 31, 33 Korner, Judith...................... 27, 28, 29, 30 Faculty Index 33 27 Alberti, K. George........................ 26, 27 Amiel, Stephanie A.......................... 26 Apovian, Caroline M....................... 27, 32 Aronne, Louis.......................... 27, 30 29 29 DeFronzo, Ralph................. 27, 28, 29, 30, 33 De Paula, Aureo......................... 28, 30 Del Prato, Stefano..................... 26, 27, 31 Dixon, John......................... 26, 27, 30 26, 27 G Gagner, Michel.......................... 27, 30 Galvao Neto, Manoel...................... 28, 31 Goldfine Allison B....................... 26, 29, 31 Goldstein, Joseph L.......................... 33 Gotto, Antonio M......................... 26, 27 Greve, Jan Willem M....................... 28, 30 J Ji, Linong........................... 27, 29, 32 Joshi, Shashank R...................... 27, 28, 30 L Laferrere, Blandine B...................... 28, 31 Lakdawala, M............................. 32 Lautz, David B.......................... 29, 31 Lebovitz, Harold E................ 26, 27, 28, 30, 34 Lefevre, Frank.......................... 29, 32 Leibel, Rudolph L........................... 33 LeRoux, Carel W......................... Ley Ruth, E............................... Li, Rui.................................. M McGraw, Timothy E.......................... 33 Mechanick, Jeffrey I.................. 26, 27, 30, 32 Mingrone, Geltrude....................... 28, 31 Moore, J.J............................. 29, 32 P Pi-Sunyer, Xavier...................... 26, 31, 32 Pomp, Alfons........................... 26, 30 Pories, Walter J.................. 26, 27, 28, 30, 34 R Roth, Jesse......................... 29, 33, 34 Rubino, Francesco..................... 26, 29, 33 S Saoud, Moh'd. Fathy........................ 29 Schauer, Phillip....................... 26, 29, 30 Schwartz, Gary J......................... 28, 31 Seeley, Randy J............................ 28 Shulman, Gerald........................... 33 Sjöström, Lars V......................... 26, 27 Staten, Myrlene......................... 29, 31 Sugerman, Harvery J...................... 27, 30 Sullivan, Sean D......................... 29, 32 V Van Der Merwe, Tess...................... W Wolfe, Bruce M.......................... Wysham, Carol H......................... Y Young, James.......................... 28, 31 33 29 29, 32 26, 32 26, 27 27, 30 Z Zimmet, Paul...................... 26, 29, 32, 34 Zirie, Mahmoud Ali.......................... 29 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 35

Share the World Congress with your Staff and Colleagues! Pre-Purchase your Congress DVD today! The information presented at the 2nd World Congress on Interventional Therapies for Type 2 Diabetes is an invaluable resource. The Congress DVD is the perfect way to share all the valuable information you ve heard here with your colleagues and staff. The Congress DVD will include the full session recordings and slides from all presentations during the Congress, including the discussions in each of the three breakout tracks. Purchase the DVD at the Congress Registration Desk or after the Congress at www.wcidt.org Cost: $165 (plus shipping) DVD orders will be mailed in summer 2011.

EXHIBITOR DIRECTORY American Diabetes Foundation Booth 207 Linda Cann +1.703.299.2068 lcann@diabetes.org The American Diabetes Association is the leading non-profit organization focused on providing resources to health care professionals and people with diabetes to improve care and patient outcomes. The association has a worldwide professional membership of over 15,000 and over 425,000 lay members. Join the new grassroots movement to Stop Diabetes. Allergan Booth 104 Pat Allen +1.714.246.4667 allen_pat@allergan.com Allergan has joined the effort to fight the growing obesity epidemic with the LAP-BAND Adjustable Gastric Banding System, the first minimally invasive surgical approach approved in the United States by the FDA, to help patients achieve sustained weight loss, realize their goals for healthy living, and reduce obesity-related risks. Covidien Booth 100 Gaurav Lamba +1.203.821.4770 Gaurav.Lamba@covidien.com Gina Baldo +1.203.821.4770 gina.baldo@covidien.com Covidien is a leading global healthcare products company that creates innovative medical solutions for better patient outcomes and delivers value through clinical leadership and excellence. Covidien manufactures a diverse range of industry-leading products in five segments including Surgical and Energy-based Devices. Please visit www.covidien.com to learn more. Ethicon Endo-Surgery Booth 102 Annie Havens +1.513.337.8645 ahavens@its.jnj.com Ethicon Endo-Surgery, a Johnson & Johnson company, develops and markets advanced medical devices for minimally invasive and open surgical procedures, focusing on procedureenabling devices for the interventional diagnosis and treatment of conditions in general and bariatric surgery, as well as gastrointestinal health, gynecology and surgical oncology. More information can be found at www.ethiconendo.com. GI Dynamics Booth 106 Wade Fox +1.781.357.3306 wfox@gidynamics.com GI Dynamics is focused on developing effective, non-surgical approaches for treating type 2 diabetes and obesity. The company's patented EndoBarrier technology has the potential to deliver medical innovations for people combating diabetes and weight problems or diabetes risk factors. Data from clinical trials demonstrate that the EndoBarrier may provide rapid improvement in glycemic control and significant weight loss by modifying metabolic pathways. Gore Medical Products Booth 202 Pamela Hickey +1.410.506.8283 phickey@wlgore.com Gore Medical Products Division has provided creative therapeutic solutions to complex medical problems for three decades. During that time, more than 35 million Innovative Gore Medical Devices have been implanted, saving and improving the quality of lives worldwide. The extensive Gore Medical family of products includes vascular grafts, endovascular and interventional devices, surgical materials for hernia repair, soft tissue reconstruction, staple line reinforcement, and sutures for use in vascular, cardiac and general surgery. 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 37

Karl Storz Endoscopy-America Inc. Booth 204 Julia Benoit +1.800.421.0837 jbenoit@ksea.com KARL STORZ Endoscopy-America, a leader for 65 years in endoscopy technologies, has earned a reputation for more than its high-quality products. The company is also well regarded for its commitment to advancing medical technology and research programs. Among these is dedication to the research of Interventional Therapies for Type II Diabetes. Qatar Foundation and Hamad Medical Corporation Booth 203 Ramez Jaber +9.744.454.0855 rjaber@qf.org.qa Qatar Foundation for Education, Science and Community Development (QF) is supporting Qatar on its journey from carbon economy to knowledge economy by unlocking human potential. This will not just benefit Qatar. It will benefit the world. QF is a private, non-profit organization founded in 1995 by His Highness Sheikh Hamad Bin Khalifa Al-Thani, Amir of Qatar. Its Chairperson and main driving force is Her Highness Sheikha Moza Bint Nasser. QF carries out its mission through three strategic pillars: education, science and research, and community development. QF s education pillar brings world-class universities to Qatar to help create an education sector in which young people can develop the attitudes and skills required for a knowledge economy. Meanwhile, its science and research pillar builds Qatar's innovation and technology capacity by developing and commercializing solutions through key sciences. Finally, its community development pillar helps foster a progressive society while also enhancing cultural life, protecting Qatar s heritage and addressing immediate social needs in the community. For a complete list of QF s initiatives and projects, visit http://www.qf.org.qa Rhinelander Gallery - Exhibits and Posters WIFI HOTSPOT AREA 206 204 202 207 205 203 106 104 102 200 201 100 ENTRANCE 38 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org

Please refer to the Abstract Book for POSTER SESSIONS Rhinelander Gallery Poster Display and Viewing: Monday, March 28: 7:00 am - 6:45 pm Tuesday, March 29: 6:30 am - 3:00 pm Poster Sessions: One of the authors is required to attend his or her poster as follows. The formal poster session will be on Monday March 28 from 5:45 pm-6:45 pm. The Presenting Author is highlighted in bold Please refer to the Abstract Book for the complete listing of Poster Sessions and Abstracts An Author Index is included immediately following the Abstracts Listing. *Special Note: Posters marked with YIA are competing for the Young Investigator Award. 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 39

40 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org

Diabetes: A Global Epidemic Diabetes currently affects 285 million people worldwide and is expected to affect 438 million by 2030. In 2010, the five countries with the largest numbers of people with diabetes were India (50.8 million), China (43.2 million), the United States (26.8 million), Russia (9.6 million), and Brazil (7.6 million). In 2010, the five countries with the highest diabetes prevalence in the adult population were Nauru (30.9%), United Arab Emirates (18.7%), Saudi Arabia (16.8%), Mauritius (16.2%), and Bahrain (15.4%). By 2030, the largest increases in diabetes prevalence will take place in developing countries. Each year a further 7.7 million people develop diabetes. Each year 4 million deaths are attributable to diabetes. An even greater number die from cardiovascular disease made worse by diabetes-related lipid disorders and hypertension. Every 10 seconds a person dies from diabetes-related causes. Every 10 seconds two people develop diabetes. Diabetes is the fourth leading cause of global death by disease. Type 2 diabetes has become the most frequent condition in people with kidney failure in countries of the Western world. The reported incidence varies between 30% and 40% in countries such as Germany and the USA. 10% to 20% of people with diabetes die of renal failure. It is estimated that more than 2.5 million people worldwide are affected by diabetic retinopathy. Diabetic retinopathy is the leading cause of vision loss in adults of working age (20 to 65 years) in industrialized countries. On average, people with type 2 diabetes will die 5-10 years before people without diabetes, mostly due to cardiovascular disease. Cardiovascular disease is the major cause of death in diabetes, accounting for some 50% of all diabetes fatalities, and much disability. People with type 2 diabetes are over twice as likely to have a heart attack or stroke as people who do not have diabetes. Indeed, people with type 2 diabetes are as likely to suffer a heart attack as people without diabetes who have already had a heart attack. At least 50% of all people with diabetes are unaware of their condition. In some countries this figure may reach 80%. At least 60% of new cases of type 2 diabetes is preventable by adopting a healthy diet and increasing physical activity. Diabetes is the largest cause of kidney failure in developed countries and is responsible for huge dialysis costs. Sources: Diabetes Atlas, fourth edition, International Diabetes Federation, 2009. Diabetes Fact Sheets: Time to Act, International Diabetes Federation, 2004. World Health Organisation Diabetes Unit - www.who.int/diabetes. Diabetes currently affects 285 million people worldwide, according to the International Diabetes Federation (IDF). 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 41

Conventional Bariatric/Metabolic Procedures Roux-en-Y Gastric Bypass (RYGB) After its first report by Edward Mason in 1967, the technique of gastric bypass has undergone several modifications. The current technique involves the use of a surgical stapler to create a small and vertically oriented gastric pouch usually less than 30 cc in size. The upper pouch, which is completely divided from the gastric remnant is anastomosed to the jejunum (between 30 and 75 cm from the ligament of Treitz). Bowel continuity is restored by an entero-entero anastomosis between the excluded biliary limb and the alimentary limb usually 75-to 100 cm distal to the gastro-jejunostomy. After RYGB, ingested food bypasses approximately 95% of the stomach, the entire duodenum and a portion of the jejunum, but bile and nutrients mix in the distal jejunum and can be absorbed through the remaining portion of the small bowel (jejunum-ileum). 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 43

Conventional Bariatric/Metabolic Procedures Laparoscopic Adjustable Gastric Banding (LAGB) The LAGB is a restrictive procedure that involves encircling the upper part of the stomach with a band-like, saline-filled tube just distal to the gastroesophageal junction. The amount of restriction may be adjusted by injecting or withdrawing saline solution from the hollow core of the band through a subcutaneous port. Sleeve Gastrectomy (SG) Sleeve gastrectomy is a component of BPD-DS; an operation that can be performed in two stages (sleeve gastrectomy first, followed by the intestinal rearrangement months later) to reduce operative time and minimize surgical risk in super-obese patients (BMI>60). The dramatic weight loss consequent to the first stage of the BPD-DS has encouraged the use of SG as a stand-alone procedure. In addition to reducing the capacity of the stomach, SG eliminates the ghrelin-rich gastric fundus and can cause changes in intra-gastric pressure and gastric motility, all of which might play a role in the mechanism of action of the operation. Sleeve gastrectomy has been also shown to substantially improve diabetes in severely obese patients as well as in experimental rodent models of diabetes. The long-term (>5 years) clinical efficacy of the procedure is still under investigation. 44 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org

Conventional Bariatric/Metabolic Procedures Figure 1A Biliopancreatic Diversion (BPD) and BPD-DS The operation involves a gastric resection (usually leaving behind a 200-500 ml sized stomach) + a long intestinal bypass. The gastric resection can be horizontal as in the Scopinaro procedure (Fig 1A) or vertical - sleeve gastrectomy in its variant named BPD-Duodenal Switch - Fig 1B). The remnant stomach is anastomosed to the distal 250 cm of small intestine (called alimentary limb). The excluded small intestine (including the duodenum, the jejunum and part of the proximal ileum) carries the bile and pancreatic secretions (biliary limb) and is connected to the alimentary channel just 50-100 cm proximal to the ileocecal valve. The short segment of small bowel where bile and nutrients mix is called common limb and is the only site where fat and starches are absorbed, whereas the alimentary limb (usually 200-250 cm in length) allows only partial absorption of nutrients. Figure 1B 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 45

Investigational Gastrointestinal Procedures Figure 2A Duodenal-Jejunal Bypass (DJB) Originally described by Rubino as an experimental procedure to investigate mechanisms of action of gastric bypass surgery, the operation consists of a stomachpreserving bypass of a short segment of proximal small intestine, equivalent to the amount of intestine bypassed in a standard gastric bypass (RYGB). A variant of this procedure includes the association of proximal intestinal bypass with sleeve resection of the stomach (DJB-SG- Fig 2B) to reduce potential for marginal ulcerations and potentially increase clinical efficacy. These procedures have been used to treat diabetes in low BMI patients (R. Cohen and others). Long-term efficacy data are not yet available and these procedures should be considered investigational in humans. Figure 2B 46 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org

Investigational Gastrointestinal Procedures Ileal Interposition (IT) The concept of ileal-interposition was first described by Koopmans and Sclafani in rodents experiments as a weight loss procedure. A small segment of ileum with its vascular and nervous supplies intact, is surgically interposed into the proximal small intestine, accelerating its exposure to ingested nutrients. IT can be performed alone or in association with sleeve gastrectomy and duodenal exclusion. The procedure requires a minimum of 3 anastomosis (vs the 2 of gastric bypass operations) and is technically complex, especially when associated with sleeve gastrectomy or duodenal exclusion. Early human studies suggest that these procedures can improve diabetes in non-obese subjects; however, long-term metabolic sequalae are unknown, and long-term safety is still to be evaluated. The procedure should be considered experimental in humans. 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 47

Disclosures Faculty Disclosures Apovian, Caroline M. Consultant: Amylin, Orexigen, Allergan, Pfizer, Johnson & Johnson, Abott, Merck, GI Dynamics Grant/Research: Atkins Foundation, MetaProteomics, Amylin, Orexigen Aronne, Louis J. Contracted Research: Amylin Pharmaceuticals, Inc., F. Hoffmann-La Roche Ltd., Novo Nordisk, Orexigen Therapeutics, Inc. Consultant/Advisory Boards: Abbott Laboratories, Amylin Pharmaceuticals, Inc., GI Dynamics, Inc., Roche Laboratories, Inc., Johnson & Johnson, NeuroSearch, Inc., Novo Nordisk, Orexigen Therapeutics, Inc., VIVUS, Inc., GlaxoSmithKline Consumer Healthcare, LP Ownership Interest: Cardiometabolic Support Network, LLC Bergman, Richard N. Consultant: Tethys Grant/Research Support (Principal): Amylin Bloomgarden, Zachary T. Consultant: BMS/AZ, Merck, Novo Nordisk Speaker s Bureau: Merck, Novo Nordisk, GlaxoSmithKlien, BMS BI Stock Shareholder (self managed): Bard, CVS, Roche, Novartis, St. Jude Brethauer, Stacy A. Consultant: Ethicon Endo Speaker s Bureau: Ethicon Endo, Covidien Grant/Research Support (Principal): Bard/Davol, Ethicon Endo Buchwald, Henry Consultant: Ethicon Endo-Surgery, Fulfillium, Metacure Grant/Reserach Support (Principal): Meacure, Ethicon Endo-Surgery, WE Gore Stock Shareholder (self managed): Metacure Cummings, David E. Grant/Research (Principal): Johnson & Johnson, Ethicon Endosurgery Darsow, Tamara Stock Shareholder (self managed): Amylin Darzi, Ara Consultant: Covidien DeFronzo, Ralph Consultant: Takeda, Amylin, ISIS, Boehringer Ingelheim Speaker s Bureau: Novo Nordisk Grant/Reserach Support (Principle): Takeda, Amylin Del Prato, Stefano Speaker s Bureau: GlaxoSmithKline, Sanofi-Aventis Grant/Research Support (Principle): Merck & Co., Sanofi-Aventis, Novo Nordisk Advisory Panels: Novartis Pharmaceuticals, Merck & Co., Roche Pharmaceuticals, Roche Diagnostics Corporation, Pfizer Inc., Eli Lilly & Co., Amylin Pharmaceuticals, Inc., Mannkind Corporation; Boehringer Ingelheim, Bristol-Meyers Squibb, Novo Nordisk Dixon, John B. Consultant: Allergan Inc., Metagenics (Bariatric Advantage), Scientific Intake Speaker s Bureau: Metagencis (Bariatirc Advantage), Eli Lilly, Nestle Australia, Optifast Medical Advisory Board Grant/Research (Principal): Allergan Inc., Nestle Australia, Optifast Medical Advisory Board, ResMed, Scientific Intake Course Director: Florida Hospital Course Co-Director: MISS Funder, John Consultant: Pfizer, Merck, CBio, Allergan, Novo NorDisk Gagner, Michel Speaker s Bureau: Ethicon, Olympus, CineMed, Coviden Grant/Research Support (Principal): GORE Galvao Neto, Manoel Consultant: Ethicon Endo Surgery, GI Dynamics Greve, Jan Willem M. Consultant: GI Dynamics Grant/Research Support (Principal): GI Dynamics Kahn, Steven H. Consultant: Boenringer Ingelheim, Eli Lilly, GlaxoSmithKlien, Intarcia Therapeutics, Merck, Novo Nordisk Grant/Research: Daiichi Sankyo Kaplan, Lee Consultant: GI Dynamics Grant/Research (Principal): GI Dynamics Keating, Catherine Grant/Research Support (Principal): Allergan Health Klein, Samuel Consultant: Amylin, Dannon/Yakult, Ethicon Endosurgery, Merck, Orexigen, Takeda Pharmaceuticals, Vivus Pharmaceuticals Speaker s Bureau: Merck Grant/Research Support (Principal): National Institute of Health (NIH), Barnes-Jewish Hospital Foundation, DSM Nutritional Products, Endo-Ethicon Surgery, Pfizer Stockholder: Aspirations Medical Technologies Endowments: Atkins Foundation Charitable Trust, Kilo Foundation Korner, Judith Grant/Research Support (Principal): Covidien Scientific Advisory Board: Nutrisystem Lautz, David Grant/Research (Principal): Covidien Lebovitz, Harold E. Consultant: Amylin Corporation, Astra-Zeneca, Biocon Pharma, Enzymotec, Glaxo Smith Kline (International), MetaCure, Sanofi-Aventis Speaker s Bureau: Glaxo Smith Kline (International) Stockholder: Merck Advisory Board: Amylin Corporation, ATTCC, Biocon Pharma, Indigene, Intra Pharmaceuticals, Merck, MetaCure, Poxel Pharma 48 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org

Disclosures Faculty Disclosures Pi-Sunyer, Xavier Consultant: Amylin, McNeil Nutritionals, Novo Nordiak, Vivus Inc., Weight Watchers, Orezigen Pories, Walter J. Consultant: Johnson & Johnson Grant/Research (Principal): Johnson & Johnson, GlaxoSmithKline Rubino, Francesco Consultant: NGM Biotech Grant/Research Support (Principal): Covidien, Roche Schauer, Phillip Consultant: Gore Grant/Research (Principal): Baxter, Covidien, Allergan Board of Directors: Remedy MD, Surgical Excellence LLC Scientific Advisory Board: Ethicon Endosurgery, Stryker Endoscopy, Bard-Davol, Barosense, Surgiquest, Cardinal/Snowden Pencer Seeley, Randy J. Consultant: Ethicon Endo Speaker s Bureau: Novo Nordisk Grant/Research Support (Principal): Ethicon Endo, Novo Nordisk Sjöström, Lars V. Consultant: AZ, Johnson & Johnson, Several Grant/Research Support (Principle): Johnson & Johnson, Roche, Sanofi Wysham, Carol H. Consultant: Amylin Pharmaceuticals Speaker s Bureau: Sanofi Aventis, Amylin Pharma Faculty With No Conflicts of Interest Accili, Domenico Adams, Ted D. Alberti, Sir K. George Amiel, Stephanie A. Basso, Nicola Brown, Michael S. Chowbey, Pradeep Cohen, Ricardo V. De Paula, Aureo Ludovico Eckel, Robert H. Ferrannini, Ele Flum, David R. Goldfine, Allison B. Goldstein, Joseph L. Gotto, Jr., Antonio M. Hill, Peter Hofmann, Bjorn Holst, Jens Juul Holst Ji, Linong Joshi, Shashank R. Kirkman, Sue Laferrere, Blandine B. Lakdawala, Muffazal Abdulkader Le Roux, Carel W. Lefevre, Frank Leibel, Rudolph L. Ley, Ruth Li, Rui McGraw, Timothy E. Mechanick, Jeffrey I. Mingrone, Geltrude Moore, John J. Pomp, Alfons Roth, Jesse Saoud, Mohammed Fathy Schwartz, Gary Shulman, Gerald Staten, Myrlene Sugerman, Harvey J. Sullivan, Sean D. Van Der Merwe, Tess Wolfe, Bruce Young, James Zimmet, Paul Zirie, Mahmoud Ali 2nd World Congress on Interventional Therapies for Type 2 Diabetes March 28-30, 2011 New York, NY, USA www.wcidt.org 49

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