Bariatric surgery highly cost-effective treatment for type 2 diabetes in the obese

Bariatric surgery is an especially cost-effective therapy for managing Type 2 diabetes in moderately and severely obese patients. These findings and others were presented today at the 2nd World Congress on Interventional Therapies for Type 2 Diabetes, hosted by NewYork-Presbyterian Hospital and Weill Cornell Medical College.

Cost effectiveness is central to the larger issue of access to surgical treatment of diabetes, says Dr. Francesco Rubino, director of the Congress and director of gastrointestinal metabolic surgery at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

Today, an estimated 285 million people around the globe suffer from Type 2 diabetes, and the number is expected to double by 2030, notes Dr. Rubino, who also serves as associate professor of surgery at Weill Cornell Medical College. "The need for effective, potentially curative therapies is urgent."

According to an analysis presented today at the Congress by an Australian researcher, bariatric surgery to treat Type 2 diabetes has been demonstrated to be very cost effective in the countries in which this research has been done - the United States, United Kingdom, Australia, and in some European settings.

The review also found that several studies have determined that bariatric surgery was not only cost effective, but cost saving, says Catherine Keating, a senior research fellow from the Health Economics Unit at Deakin University in Melbourne, who made the presentation. For obese patients diagnosed with Type 2 diabetes during the two years prior to bariatric surgery, one study found that the upfront costs of surgery would be fully recouped through the prevention of future health care costs to treat Type 2 diabetes. This study was undertaken alongside a clinical trial that found that remission of Type 2 diabetes was five times greater in surgically treated patients, relative to those receiving conventional therapies, she says.

"For this patient group bariatric surgery generates both cost savings and health benefits," Ms. Keating says. "This provides the strongest rationale yet for implementation of this treatment on economic grounds."

Treatment studies have shown that bariatric surgery, initially developed for the treatment of morbid obesity, can improve or normalize blood sugar levels, reduce or even eliminate the need for medication, and lower the risk of diabetes-related death.

A number of new cost-effectiveness studies have been discussed at the meeting, says Dr. David Reed Flum, who co-chairs the Congress's policy track. "As health care costs soar, the obligation of all those involved in this issue is to understand the way resources are currently being applied to the treatment and prevention of diabetes and to explore what the future impact on health care resources might be if surgery becomes a meaningful part of the public health response to the diabetes epidemic," says Dr. Flum, professor of surgery and health services at the University of Washington School of Medicine.