Weight-loss surgery ‘most effective’ treatment for type 2 diabetes patients

Metabolic surgery can free two-thirds of patients with type 2 diabetes from the use of insulin, new research suggests.

An analysis of post-surgery outcomes of nearly 2,000 patients with obesity and diabetes requiring insulin, co-ordinated by the Irish Society for Clinical Nutrition and Metabolism (Irspen) and the British Obesity and Metabolic Surgery Society found that surgery is more effective and cheaper than insulin.

Some 67 per cent of patients were no longer using insulin one year after metabolic surgery – and 37 per cent achieved remission of their diabetes altogether, the analysis found.

Metabolic surgery is a term used to describe weight loss treatments and procedures, such as a gastric bypass, to treat metabolic diseases such as diabetes in obese people.

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The research included a broad cohort of patients across Ireland and the UK and analysed their outcomes between 2009 and 2017.

Prof Helen Heneghan from the National Metabolic Surgery Centre at St Vincent's hospital, said "on average patients also lost around a quarter of their bodyweight and the improvements persisted for at least four years".

Prof Heneghan said prior to this analysis, questions remained if surgery would be as effective for patients with type 2 diabetes requiring insulin, as these patients also have a higher chance of diabetes complications.

“This research now confirms metabolic surgery is also the most effective medical treatment for the majority of patients with more severe type 2 diabetes who use insulin,” she said.

Type 2 diabetes develops when the body becomes resistant to insulin or when the pancreas is unable to produce enough insulin. Obesity and age both increase the risk of developing type 2 diabetes.

There are more than 200,000 people living with diabetes in Ireland, according to Diabetes Ireland, most of whom have type 2 diabetes.

In a second part of the study, Irspen member Prof Carel le Roux said surgery was also found to be more cost effective than medication.

“The researchers costed the surgery against if the same patients had been treated with medicines alone. Although an operation costs €8,000, researchers found that this figure was less than the ongoing cost of medications,” she said.

“With costs of treatment side-effects and any complications of diabetes were also considered, the average patient treated with surgery was expected to save the health system €4,000 over five years, while also living with better health outcomes.”