Offer Obese Patients Weight Loss Surgery To Tackle Type 2 Diabetes, Experts Urge

'We have a pandemic on our hands.'

25/05/2016 10:07

Obese patients should be given weight loss surgery in order to cut the numbers of people suffering from Type 2 diabetes, new guidelines suggest.

In a new report created by a worldwide coalition of health organisations, experts say that following weight loss surgery, about half of patients go into remission from Type 2 diabetes that lasts at least five years.

Because of this, they're calling for surgery to be recognised as a standard, cost-effective treatment for the disease.

The new guidelines suggest the UK should be aiming to carry out up to 50,000 weight loss operations every year to bring it into line with other European countries.

Currently, UK doctors complete around 6,000 of the procedures every year.

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The new report has been created by some of the world's leading experts on diabetes, including Diabetes UK, the American Diabetes Association, Diabetes India and the International Diabetes Federation.

It suggests anyone with Type 2 diabetes who has a body mass index (BMI) of 40 or more should be offered surgery regardless of their blood sugar levels.

Patients with a BMI of 30 or over - the threshold for being clinically obese - should also be offered surgery as an option if their blood glucose levels are not well-controlled despite taking tablets, insulin or following weight loss programmes.

The report estimates that in the UK, around 3.5 million people have diabetes, but around 500,000 do not even know they have it.

If left untreated, Type 2 diabetes can lead to eye and nerve damage, kidney failure, amputations, heart disease and strokes.

Professor Sir George Alberti, co-author of the report, said "we have a pandemic on our hands", adding that there were now at least 422 million people with diabetes across the globe.

"We are changing the paradigm here, we are not talking about the treatment of obesity, we are talking about the treatment of diabetes," he said, according the PA.

"The more severe amongst my colleagues would say you just need to diet and exercise and it goes away... but getting people to sustain that for a long period of time is almost impossible.

"People say 'it's all your own fault, just lose weight', but that doesn't help anybody. There are people who find it very, very difficult and are miserable as sin as a result."

He added that the UK is also way behind other countries when it comes to offering weight loss surgery to people with, or at risk, of Type 2 diabetes.

"If you consider that we've got... half a million severely overweight with diabetes, then we are just scratching around. It's getting through to our colleagues and the NHS that this (surgery) is a real treatment for diabetes," he said.

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Symptoms of Type 2 Diabetes

According to Professor Alberti, 11 clinical trials have shown that 30% to 50% of people who received wight loss surgery had remission from diabetes for at least five years.

"If you can buy five years of normal blood glucose even if you remit afterwards, that is a five-year further delay in developing eye damage, kidney damage... so anything you gain is very much on the plus side," he said.

Francesco Rubino, one of the experts behind the guidelines and professor of metabolic and bariatric surgery at King's College London, said weight loss surgery is a "very powerful treatment" for Type 2 diabetes.

He added that patients who have weight loss surgery have far better blood sugar control than those who try to lose weight naturally as a means of controlling their diabetes. 

"Surgery is a true diabetes intervention," he said, adding that it made "no medical sense" and "no economical sense"  to continue patients on pills or insulin that was not working.

The report suggests the cost of each operation to the NHS will be between £5,000 and £6,000.

Simon O'Neill, director of health intelligence at Diabetes UK, commented: "We strongly support the call for obesity surgery to be fully recognised as an active treatment option for Type 2 diabetes alongside established forms of Type 2 diabetes treatments, such as lifestyle changes, and blood glucose lowering medications.

"This is because there is a wide body of evidence that shows surgery is an effective treatment option for Type 2 diabetes and can be cost effective for the NHS.

"However, many people who stand to benefit from this potentially lifesaving treatment are missing out due to needless barriers to obesity surgery services.

"Even people who meet the criteria for the surgery are being made to wait too long, even though we know that people with Type 2 diabetes benefit most from the surgery if it is carried out closer to the time they were diagnosed."

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