UK to offer more weight loss surgery to type 2 diabeteics

by Barbara Hewitt on November 28, 2014

More people in the UK who have type 2 diabetes and are obese are set to be offered weight loss surgery in a bid to manage a huge rise in the disease.

New guidelines issued by the National Institute for Health and Care Excellence (NICE), which advises the NHS in England, said obesity was an immense problem, especially when  related to diabetes.

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The new guidelines state that obese people with recently diagnosed type 2 diabetes should be assessed for weight loss surgery quickly

It revealed that around 10% of the NHS budget is now spent on treating diabetes and its complications and said obesity had a ‘huge personal health cost to individuals and an enormous financial cost to the NHS’.

‘Obesity is directly linked to type 2 diabetes, fatty liver disease, cancer, high blood pressure, heart disease, stroke, arthritis and it affects people’s mental health,’ said professor Mark Baker, the centre for clinical practice director at NICE.

‘It is a major issue, if not the major issue, for the health service in the coming years,’ he explained.

The NICE guidelines state that obese people with recently diagnosed type 2 diabetes should be assessed for weight loss surgery quickly. As a first course of action, NICE recommends diet changes and increased exercise to reduce weight, followed by drugs treatment.

When obesity is potentially life-threatening, weight loss surgery is available on the NHS, as a last resort.

Last year, 6,500 weight loss procedures were performed in the UK, with gastric bypass and sleeve gastrectomy the most common types of surgical intervention. Both work on the principle of surgically altering the digestive system so it holds less food and makes the patient feel fuller sooner after eating.

NICE recommends that all patients with a BMI of 35 or over who have recent-onset type 2 diabetes be assessed for surgery. Patients must have tried and failed to achieve clinically beneficial weight loss by all other appropriate non-surgical methods and be fit for surgery.

Weight loss surgery is also beneficial for people with a BMI of 30-34.9 who have recent-onset type 2 diabetes that is very poorly controlled.

NICE recommends that doctors consider surgery for people of Asian family origin who have recent-onset type 2 diabetes at a lower BMI than other populations, as the point at which the level of body fat becomes a health risk varies between ethnic groups. Asian people are known to be particularly vulnerable to the complications of diabetes.

‘We know that surgery can make a real difference for people with recently diagnosed type 2 diabetes, so the guideline now recommends that if someone is diagnosed with type 2 diabetes and their BMI is 35 or over, then they should be offered an early, rapid assessment for weight loss surgery,’ said Dr. Rachel Batterham, head of Obesity and Bariatric Services at University College London Hospital Trust who was involved in developing the guidance.

‘If we look at the latest report of bariatric surgery done in the UK, there were 4,000 patients with type 2 diabetes who had surgery. Of them, 65% were no longer on any diabetes medications 2 years later. The health benefits of weight loss surgery are so great that it should be considered as part of the treatment for obese diabetics. The earlier you have the surgery in your diabetes course, then the more likely you are to have remission or a really good improvement,’ she added.

The guidelines also point out that while the cost to the NHS of bariatric surgery was about £6,000 per person, in the long term, money will be saved on the cost of treating type 2 diabetes caused by obesity.

It is estimated that an additional 5,000 weight loss surgeries will be carried out each year if the guidance is fully implemented.  Experts reckon the cost could be recouped in two to three years.

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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