Bariatric Surgery as a Cure for Diabetes: Can we Stomach it?

LONDON - For the first time ever, experts in bariatric surgery gave a lecture on
how weight loss surgery for morbidly obese patients can cure type 2 diabetes,
at the Diabetes UK Annual Professional Conference in Glasgow.

‘The changing face of diabetes’, was the theme for the 2009 conference,
introducing the new developments in bariatric research and clinical practice
for the future.

The session entitled “Bariatric surgery as a “cure” for diabetes: can we
stomach it?” Was one of only three plenary sessions throughout this year’s
conference, and tackled integrating obesity management into diabetes care,
with both diabetic and surgical expert views.

The contribution of bariatric surgery to the conference comes just after
a report published in the American Journal of Medicine which suggests type 2
diabetes was completely resolved in 78% of patients undergoing bariatric
surgery - findings that were maintained for two years or more.[1]

In 2007, 24% of adults (aged 16 or over) in England were classified as
obese. This represents an overall increase from 15% in 1993, with the most
severely overweight of these considered `morbidly’ obese.[2] Obesity
represents one of the most serious public health problems in Europe, and
morbid obesity has been associated with over 30 illnesses. The risk of
developing type 2 diabetes is 20 times greater for people with severe obesity
(BMI > 35kg/m2) than for those with BMI of between 18-25 kg/m2.[3]

Surgical treatment for morbidly obese individuals has provided a
well-documented long-term effect on their weight, quality of life[4] and
diabetic conditions. On average, the weight reduction after 1 to 2 years is
as much as 32% with gastric bypass, 25% for banding[5] (compared to 5-10%[6]
weight loss seen with non-surgical treatments).

This form of surgery (approved by NICE) not only produces substantial
weight loss, but provides rapid improvement of type 2 diabetes, even before
much weight loss has occurred, through alterations in gut
hormone-pancreas-brain pathways. Many of those with diabetes find that their
blood glucose levels normalise and they can stop taking medication.[7]

Dr Nicholas Finer, Consultant Endocrinologist, at UCL Hospitals NHS
Foundation Trust and member of NICE advisory board for bariatric surgery,
commented: “I very much welcome Diabetes UK’s acceptance of the potential for
surgical treatment of severe obesity to have an important role in diabetes
management. Bariatric surgery not only helps achieve substantial weight loss
and weight loss maintenance, but significantly improves and even resolves
other associated conditions such as type 2 diabetes. Our challenge is to
increase accessibility and availability of this treatment”

For many of the morbidly obese, bariatric surgery such as a gastric
bypass is the only long-term option.[8]

References

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[1] Buchwald et al. Weight and Type 2 Diabetes after Bariatric Surgery:
Systematic Review and Meta-analysis, The American Journal of Medicine, (3).
2009.

[2] Health Survey for England 2007 Latest Trends at
www.ic.nhs.uk/pubs/hse07trends.

[3] Field A. Impact of overweight on the risk of developing common
chronic diseases during a 10-yaer period. Archives of Internal Medicine (161)
2001.

[4] Karlsson et al. Ten-year trends in health-related quality of life
after surgical and conventional treatment for severe obesity: the SOS
intervention study. International Journal of Obesity, (8) 2007.

[5] Sjöström et al. Effects of bariatric surgery on mortality in Swedish
obese subjects. New England Journal of Medicine, (8) 2007.

[6] Torgerson et al. Xenical in the prevention of diabetes in obese
subjects (XENDOS) study. Diabetes Care, (1). 2004

[7] Suter et al. European experience with laparoscopic Roux-en-Y gastric
bypass in 466 obese patients. British Journal of Surgery. May 2006

[8] Adams TD et.al. Long-Term Mortality after Gastric Bypass Surgery. New
England Journal of Medicine, (4) 2007.

Source: Biss Lancaster plc

Media contact details: Joanna Dixon, Joanna.dixon at bisslancaster.com, +44-(0)20-7467-9202