Weight-loss surgery worthwhile for diabetes

As a strategy for treating type 2 diabetes in obese individuals, gastric surgery to induce weight loss is effective and worth the cost, investigators in Melbourne, Australia, report.

A recent clinical trial showed that "surgically induced weight loss leads to the remission of type 2 diabetes in the majority of obese patients," Catherine L. Keating at Monash University and others note in the medical journal Diabetes Care.

Using data from that trial, the team estimated the costs and benefits of weight-loss surgery as a way to treat type 2 diabetes.

The analysis covered 60 obese patients with diabetes diagnosed within the previous two years. Thirty were assigned to adjustable gastric banding, which reduces the capacity of the stomach, and 30 were assigned to best available medical management.

Remission of their diabetes was achieved by 22 patients (73 percent) treated surgically and 4 patients (13 percent) treated medically.

The researchers calculate that, over a two-year period, the cost of resolving one case of diabetes was $25,500 with conventional medical treatment, and $16,600 more than that with surgical therapy.

This cost is within the threshold of $50,000 - $60,000 that is usually considered acceptable from a societal standpoint.

Keating and her associates also extrapolated the costs and outcomes to the lifetime of the patients in the study.

Compared to conventional therapy, surgically induced weight loss was actually associated with health care savings, as well as with health benefits, they report.

Specifically, they calculate, "this analysis suggests that after 10 years the return on investment of surgical therapy is fully recovered through savings in health care costs."

SOURCE: Diabetes Care, April 2009.