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NICE propose more weight loss surgery to tackle Type 2 diabetes

By Editor
11th July 2014
Clinical guidance, Latest news NICE

The National Institute of Health and Care Excellence (NICE) is proposing more weight loss surgery in England to tackle Type 2 diabetes.

The health watchdog is proposing to lower the threshold for bariatric surgery for people with newly-diagnosed Type 2 diabetes to a BMI of 30. Until now, it has said that people with Type 2 diabetes could be considered for a gastric band at a BMI of 35.

The move could see an extra 850,000 people eligible for surgery, according to Diabetes UK. Being overweight is a risk factor in the development of Type 2 diabetes.

The draft of NICE’s updated guidance on obesity, which also proposes that very-low calorie diets should be used more selectively, is available for consultation from today.

Simon O’Neill, Director of Health Intelligence and Professional Liaison at Diabetes UK, said: “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.

“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.

“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.

“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.

“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.

“That’s why we are pleased to see that these new NICE guidelines are cautious about the use of low-calorie diets and take into consideration the need for comprehensive support and planning for those people who do take this approach forward.”

The updated draft guideline is available for consultation on the NICE website.

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