Type 2 diabetes

Call to embrace metabolic surgery for T2D

Thursday, 2 Jun 2016

The Australian Diabetes Society has welcomed new guidelines advocating the use of metabolic surgery in the treatment of obese patients with type 2 diabetes.

And they are preparing to rally other diabetes groups throughout the country to lobby the Federal Government for more funding to allow better access to metabolic surgery for T2D patients who really need it.

The new guidelines, published in the American Diabetes Association Journal Diabetes Care had been endorsed by 45 professional diabetes bodies around the world, including the ADS.

President, Associate Professor Sof Andrikopoulos said he had taken responsibility for endorsing the guidelines on behalf of the ADS, and saw them as one of the most significant changes to treatment standards in many years.

“If you look at all the treatment algorithms there is no provision for surgery,” he said. “It is all pharmacotherapy. This is providing another option for that patient who is very difficult to treat.”

The guidelines advocate so-called metabolic surgery, which is identical to the bariatric surgery used to treat obesity, as a standard treatment option for certain patients. It follows a number of clinical trials that have shown surgery can significantly improve blood sugar levels.

In some cases the gains have been shown to be more effective than those achieved through lifestyle changes or drug therapies, and has even led to long-term remission of T2D in some patients and in others less reliance on medication for disease control.

Professor Andrikopoulos said it was important to point out that this treatment option was not for everyone and would not replace pharmacotherapy. He said it would be best suited to T2D patients with poorly controlled disease and a BMI over 35. And he stressed it was not intended to be a first line treatment in any circumstance.

“You should consider this, you can recommend metabolic surgery for those patients who are having difficulty controlling their diabetes due to weight issues,” he urged clinicians. “I predict there will be a shift in the number of surgeries that are done (as a result of these guidelines).”

He said the guidelines paper would be used in Australia to lobby the government for more funding for metabolic surgery.

“Even though there is an initial outlay (for the surgery) there are potential long term economic and health benefits,” he said.

“I think we’re going to get together with other diabetes organisations in Australia to lobby government for more access to metabolic surgery. It just makes sense.”

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