Weight loss surgery ‘puts advanced type 2 diabetes into remission’
Obese people with the severest form of type 2 diabetes can have their condition significantly improved or put into remission by weight loss surgery, new research has shown.
A large-scale collaborative study between the British Obesity and Metabolic Surgery Society (BOMSS) and the Population Health Research Institute at St Georges, University of London, found there are also huge cost saving implications too.
For some time now, weight loss operations such as gastric bypass and sleeve gastrectomy have been known to improve or put early or mild type 2 diabetes into remission among people with obesity. However, small studies had previously suggested that surgery might be less effective for those with insulin-dependant type 2 diabetes, who have a higher chance of developing diabetes complications.
Patients with obesity and severe diabetes have not previously been prioritised for surgery, but our findings suggest that offering weight loss surgery to this group of patients not only leads to improved health, but by reducing the need for multiple daily medications, benefits the taxpayer Lead researcher Mr Omar Khan
To investigate the effects of surgery, researchers used the National Bariatric Surgical Registry to analyse the outcomes of nearly 2,000 patients living with obesity and type 2 diabetes requiring insulin who had surgery between 2009 and 2017.
- Two out of three people no longer needed insulin at one year after their surgery
- Type 2 diabetes completely disappeared in one in three people one year after their surgery
- People on average lost around a quarter of their body-weight
These findings are of particular relevance in the COVID-19 era, since it is known that people with diabetes and obesity are at higher risk of dying if they contract the virus. Weight loss surgery which reverses diabetes and obesity could also decreases deaths from COVID-19.
Treating type 2 diabetes and its complications costs the NHS £10 billion yearly, so next the researchers looked at the overall costs in people who had surgery compared to a similar group of people who did not
Although each operation costs the NHS around £6,000, researchers found that this figure was less than the costs for medications to treat their type 2 diabetes. When costs of avoiding the complications of diabetes were also considered, the average patient treated with surgery was expected to save the NHS £4,229 over a five-year timeframe.
Lead researcher Mr Omar Khan, bariatric surgeon from St George’s, University of London, said: “Patients with obesity and severe diabetes have not previously been prioritised for surgery, but our findings suggest that offering weight loss surgery to this group of patients not only leads to improved health, but by reducing the need for multiple daily medications, benefits the taxpayer.”
Nikki Joule, Policy Manager at Diabetes UK, said: “This study strengthens existing evidence that bariatric surgery can help some people with obesity and insulin-treated type 2 diabetes to go into remission, and in turn, that this approach can save the NHS vital funds compared to the best alternative non-surgical treatments.
‘Despite the known clinical benefits of bariatric surgery for type 2 diabetes, we know that people who meet the current NHS criteria are often not offered this treatment. We urge the NHS to take action to increase the provision and take-up of bariatric surgery so that more people have the chance of putting their type 2 diabetes into remission.”
The findings have been published in PLOS Medicine.