Type 2 diabetes and bariatric surgery

16 Mar 2021 | Bariatric Surgery, Evidence Based Medicine, Gastric Bypass, Sleeve Gastrectomy, Weight Loss

A recent PwC report on type 2 diabetes has been getting some media coverage over the past few days.  This report looks at the increasing prevalence of type 2 diabetes in Aoteoroa/New Zealand and the cost of preventing and treating the complications it can lead to.  Although the report calls for better prevention, and also improved funding of newer medications already available overseas to treat this disease, little has been mentioned about the role of bariatric surgery.

For many suffers of type 2 diabetes, this condition is strongly linked with increased body weight and the insulin resistance that this can cause.  There is strong evidence that bariatric surgery can lead to durable remission of type 2 diabetes in those who also have an elevated body mass index (BMI), and also is likely to be one of the most cost effective treatments, particularly when undertaken early in the disease.

International guidelines recommend that bariatric surgery be considered for all patients with a new diagnosis of type 2 diabetes who also have a body mass index of greater than 35kg/m2, and probably also those with a body mass index of greater than 30kg/m2.  Timing is also very important as the effectiveness of bariatric surgery is largely dependant on the length of time people have had the disease – remission is almost guaranteed in those have bariatric surgery within two years of diagnosis of diabetes, but much less likely when undertaken more that 10 years ofter diagnosis.

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