UK could recommend bariatric surgery for type 2 diabetes

by Barbara Hewitt on July 14, 2014

More overweight people with type 2 diabetes in the UK could be offered bariatric surgery after the national body responsible for health recommendations issued new draft guidance.

The National Institute for Health and Care Excellence (NICE) recommends more weight loss surgery for people with type 2 diabetes and also says that very low calorie diets should be used more selectively.


Being overweight is an important risk factor in the development of type 2 diabetes

Being overweight is an important risk factor in the development of type 2 diabetes, with data released last week indicating more than 700 people are diagnosed with the condition every day in the UK.

However, Diabetes UK, the leading charity in the country, has warned that although bariatric surgery can have a positive effect, it also carries serious health risks.

‘For most people, losing weight can be very difficult. For some, as well as a healthy diet and physical activity, additional treatments include medication and surgery,’ said Simon O’Neill, director of Health Intelligence and Professional Liaison at Diabetes UK.

‘Although studies have shown that bariatric surgery can help with weight loss and have a positive effect on blood glucose levels, it must be remembered that any surgery carries serious risks. Bariatric surgery should only be considered if serious attempts to lose weight have been unsuccessful and if the person is obese,’ he explained.

‘Bariatric surgery can lead to dramatic weight loss, which in turn may result in a reduction in people taking their type 2 diabetes medication and even in some people needing no medication at all. This does not mean, however, that type 2 diabetes has been cured. These people will still need to eat a healthy balanced diet and be physically active to manage their diabetes,’ he pointed out.

He also believes that while there should be caution about very low calorie diets, they should not be dismissed as part of a supervised treatment plan. The charity is currently conducting research into these types of diets to find out if they can be maintained in the long term.

‘At Diabetes UK we are funding the largest study in the UK which compares the long term health effects of current type 2 diabetes treatments and those of a very low calorie diet followed by a long term approach to weight management. We hope this will provide insight into the possible health benefits of intensive weight control and find out whether these can be maintained in the long term as part of routine NHS care,’ he said.

‘If a very low calorie diet can be used within routine GP care to bring about and maintain weight loss and type 2 diabetes remission, it could ultimately be of enormous benefit to millions of people living with the condition. But the full results will not be available until 2018. Until we have the evidence that this approach is more effective that the current best available treatment, we do not recommend that people with type 2 diabetes attempt to lose weight this way,’ he added.

The NICE consultation on the recommendations is open until 08 August 2014. If approved, the recommendations could see thousands of people receive surgery. NICE’s Professor Mark Baker, said the numbers could amount to between 5,000 and 20,000 new operations per year, but he stressed that surgery would not be offered to everyone.

‘The first line of attack will be diet and exercise and we would expect clinicians to consider the risks and benefits of surgery for patients,’ he said, adding that some would not be operated on because of age and other health risks.

He pointed out that there is considerable evidence that relatively early bariatric surgery can make diabetes much easier to manage, and in a proportion of cases, actually reverse the condition.

The opinions expressed in this article do not necessarily reflect the views of the Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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