International experts say weight loss surgery should treat type 2 diabetes

Jack Woodfield
Wed, 25 May 2016
International experts say weight loss surgery should treat type 2 diabetes
International experts have called for bariatric (weight loss) surgery to be routinely offered to as many as 100,000 people with type 2 diabetes because it cures the condition in roughly half of people with obesity.

This statement, published in Diabetes Care, follows recommendations from UK experts on Monday also advocating that the NHS should perform more bariatric surgery.

The National Institute for Health and Care Excellence (NICE) recommends weight loss surgery for people with type 2 diabetes who are obese or overweight and cannot maintain good control of blood glucose levels through drugs and lifestyle changes.

However, only 6,000 people with type 2 diabetes receive surgery annually, which has dropped from 8,800 people three years ago. Because operations cost between £5,000 and £6,000, the NHS has come under financial pressure when performing surgery, but a coalition of 45 international organisations, doctors and researchers believe surgery should be offered to more people because it could save money on diabetes medication and treating complications in the long term.

Their new guidelines, backed by organisations such as the International Diabetes Federation (IDF), say that anyone with a BMI of 30 should have weight loss surgery if their blood sugar is poorly controlled despite treatment, and anyone with a BMI of 40 should be offered surgery.

The guidelines are based on a review of randomised trials showing weight loss surgery leads to remission in up to half of type 2 diabetes cases. This effect can last for up to five years providing patients eat smaller portions of food after surgery and make good lifestyle choices.

This makes weight loss surgery a "very powerful treatment", according to Professor Francesco Rubino, one of the experts behind the guidelines and professor at King's College London.

These recommendations are for anybody with type 2 diabetes, regardless of how long they have had the condition, and the researchers claim over 100,000 people per year are likely to meet this new criteria.

Professor Sir George Alberti, co-author of the guidelines, said: "We are changing the paradigm here, we are not talking about the treatment of obesity, we are talking about the treatment of [type 2] diabetes."
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