Type-2 diabetics ‘should be offered weight loss surgery’

Type 2-diabetics should be offered weight loss surgery to cure their condition, according to guidelines backed by 46 international health organisations.

The groups say that diabetes is pandemic, and that drugs and lifestyle management is not enough to reverse the trend. A study by the World Health Organisation, for instance, found that diabetes cases have quadrupled since 1976.

Instead, gastric bypass operations should be offered as a matter of routine, alongside the drugs, diet and exercise programmes currently in use, according to guidelines backed by groups including the International Diabetes Foundation and the American Diabetes Association.

Gastric bypass surgery, in which the size of the stomach is decreased, is believed to be effective against type-2 diabetes because patients subsequently eat less and this causes a drop in blood sugar levels.

The researchers also say that surgery changes the patients’ gut bacteria in a way that lowers blood sugar levels.

The guidelines were published in the journal Diabetes Care.

A study in the British Medical Journal earlier this month found that the cost of routinely offering bariatric surgery could be recouped within three years, and that the procedure enables patients to reduce their weight by as much as 25 to 35 per cent in a year.

Instant analysis
It is well recognised that the dramatic rise in obesity in the developed world is triggering the major increase in diabetes that clinicians are seeing in patients every day. Apart from the massive impact on morbidity and mortality that diabetes often has, the impact to the NHS in terms of the cost of treating its complications cannot be overstated.

These guidelines suggest a radical approach to the problem — that gastric bypass surgery should be routinely offered alongside lifestyle changes and medication. The logic here is that money spent upfront will reduce the cost of treatment and complications — some £11 billion a year presently — in the future. In Britain, current estimates are that it would cost £60 million treating all eligible diabetic patients this way. But, with the NHS in the grip of its worst spending deficit for many years, this type of surgery will certainly never become a routine treatment option any time soon. In the mean time, the advice to the overweight diabetic population remains the same — lose weight as best you can, using a combination of diet and exercise.
RH
Research score: 3/5