Treating Type II Diabetes with Weight Loss Surgery
The 4th World Congress on Interventional Therapies for Type 2 Diabetes was just held in New York City. This is a multidisciplinary forum composed of MD’s, scientists, and policy makers from over 60 countries. Their goal is to continue to refine the guidelines for the treatment of type 2 diabetes.
I mention this meeting only to highlight the ongoing efforts to find a cure for this devastating, progressive disease. Let’s review the current information on type 2 diabetes. There is a mountain of evidence that metabolic and bariatric surgery is the best treatment for type 2 diabetes patients. It is safe, effective, and durable. It saves lives and is cost effective.
It is safe. A recent study of 66,678 diabetic patients was conducted to evaluate complication rates for common operations, including bariatric procedures, open heart surgery, knee scopes, appendectomy, gallbladder, and hysterectomy surgeries. The gastric bypass had the lowest complication rates followed by hysterectomy and gallbladder surgeries.
Metabolic and bariatric surgery is effective. The current success rate associated with changes in lifestyle and drug therapies for treating type 2 diabetes is not very good. A recent study of about 5,000 patients showed that with lifestyle changes and drug therapy only 52% of patients achieved A1C less than 7. Multiple studies that compare medical resolution versus surgical resolution for type 2 diabetes have been completed. The surgical groups in every study had a very high rate of remission and the medical group had a very low, to no, rate of remission. Further investigation shows that the results from these studies are maintained long-term.
Metabolic surgery saves lives. A review of studies that compare mortality in patients that had weight loss surgery versus no surgical therapy demonstrate a marked reduction in risk of death of 50-80% in the surgical group.
Surgery is cost effective. The lifetime cost for treating type 2 diabetes is immense. A newly diagnosed 35-year-old female with type 2 diabetes can expect $130,800 in direct medical costs over her lifetime, with 53% of the cost attributed to complications of type 2 diabetes. In contrast, the average cost for bariatric surgery is $25,000.
The bottom line is that metabolic and bariatric surgery for the treatment of type 2 diabetes is safe, effective, and durable. It will reduce your risk of death and lead to a longer life expectancy. It is also cost effective and will help prevent the progressive, debilitating nature of this disease.
The indications for patients with type 2 diabetes who are candidates for bariatric surgery:
–BMI greater than 40—surgery is recommended
–BMI 35-39 with diabetes not well controlled—surgery is recommended
–BMI 30-35 with diabetes not well controlled—surgery should be considered
All metabolic and bariatric surgeries should be conducted in high volume centers with experienced surgeons. At the Colorado Bariatric Surgery Institute, we perform about 300 robotic bariatric procedures yearly and they are done with the most state-of-the-art technology. Robotic bariatric surgery is a more precise operation, allowing for less pain and bleeding and a faster recovery time. Please call us to schedule a consultation (303-861-4505) or visit our website www.coloradobariatric.com for more information.
Dr. Tom Brown
Colorado Bariatric Surgery Institute