Surgery more effective and cheaper than insulin for people with severe type 2 diabetes
Surgery has been found to be more effective and cheaper than insulin for patients with type 2 diabetes – and can free the majority from future use of insulin.
Research coordinated by the Irish Society for Clinical Nutrition and Metabolism (IrSPEN) and the British Obesity and Metabolic Surgery Society analysed the post-surgery outcomes of nearly 2,000 patients with obesity and diabetes requiring insulin.
Professor Helen Heneghan from the National Metabolic Surgery Centre at St Vincent’s University Hospital, said 67% of patients were no longer using insulin one year after metabolic surgery – and 37% achieved remission of their diabetes altogether.
“On average patients also lost around a quarter of their bodyweight and the improvements persisted for at least four years,” said Professor Heneghan.
The research included a broad cohort of patients across Ireland and the UK and analysed their outcomes between 2009 and 2017.
Professor Heneghan said gastric operations are well established as the most clinically and cost effective treatment for most patients with early or mild diabetes, but the question remained if surgery would be as effective for patients with type 2 diabetes requiring insulin – as these patients also have a higher chance of diabetes complications (such as blindness, kidney failure, limb amputation and heart disease).
“This research now confirms metabolic surgery is also the most effective medical treatment for the majority of patients with more severe type 2 diabetes who use insulin,” she said.
Type 2 diabetes affects 200,000 people. It is a major risk factor for COVID-19 and treatment for the condition alone accounts for more than 10% of the overall healthcare budget.
In a second part of the study IrSPEN member Professor Carel le Roux said surgery was also found to be more cost effective than medication: “The researchers costed the surgery against if the same patients had been treated with medicines alone. Although an operation costs €8,000, researchers found that this figure was less than the ongoing cost of medications.
“With costs of treatment side-effects and any complications of diabetes were also considered, the average patient treated with surgery was expected to save the health system €4,000 over five years, while also living with better health outcomes.”
Laurence Kelly, a patient needing daily insulin injections for his type 2 diabetes for many years, no longer requires these injections after his operation.
“These findings show the benefits of the HSE making metabolic surgery more widely available to more public patients in Ireland. The surgery not only gave me significant improvement in my health, but is also cost-effective for the HSE within a short payback time,” he said.
Ireland’s public health system has the lowest funding per capita for obesity treatment in the EU. In France for example 40 times more gastric surgeries per head of the population are carried out compared to in Ireland.
See also www.irspen.ie
Ronan Cavanagh, Cavanagh Communications: (086) 317 9731.