Does weight-loss surgery prevent the onset of diabetes type II?

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Offline maruppharm

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Scientists from the University of Gothenburg in Sweden have come forward with an interesting study into type II diabetes and whether in fact the onset of the condition can be delayed or prevented by simple weight loss surgery. While the link between type II diabetes and obesity is not new, and it is indeed central to those who develop the condition, it had been unclear whether weight loss surgery would have a significant impact.
The findings have been very informative and indeed it seems that selective weight loss surgery could indeed prevent the onset of type II diabetes across a large number of the population. We will now take a look at more details of the study and what this means for the future of diabetes treatment and instances of diabetes.

The Swedish study

The study by the University of Gothenburg saw 1658 volunteer step forward and 1771 agree to be part of a control group to base the study. Historically there have been studies about the link between weight loss surgery and the instances of type II diabetes although these have been targeted towards remission of diabetes rather than prevention.

Perhaps the most interesting fact is that of the 1658 volunteers who stepped forward for surgery, namely stomach stapling, the risk of diabetes over a 10 to 15 year period fell to about one in 150 per year. Those who received the standard treatment associated with diabetes prevention were more at risk of developing the condition with a rate which was one in 35 per year. Indeed the scientists who undertook the study also believe that the group who underwent surgery were at an even greater risk of developing diabetes than the control group. So what does this mean?

Does surgery help?

There is no doubt that significant weight loss, brought about by stomach stapling, does have a material impact upon the chances of developing type II diabetes which is seen by many as a lifestyle condition. The results of this study could be far-reaching because until now major weight loss surgery has only been undertaken to reduce the impact of diabetes as opposed to preventing the onset of the condition.

The very fact that, as we touched on above, the improvement in the prevention of diabetes was even stronger in the volunteer group compared to the control group than it first looked is another positive factor. This opens up a number of opportunities for the medical profession and the potential to target those most at risk of diabetes type II and offer them the chance of weight loss surgery at a relatively early stage to prevent or delay the onset of the condition. It is not known whether those in either of the volunteer group or the control group will develop type II diabetes in later life but the fact that the impact within 10 to 15 years has been proven is interesting in itself.

The only downside to the discovery by Swedish scientists is the fact that with 285 million people worldwide suffering from type II diabetes, and an unknown quantity potentially at risk, it is impossible to undertake this type of surgery for everyone as it costs between $11,000 and $26,000. The impact upon government budgets would be enormous and while it would save potentially hundreds of millions or billions of dollars in the future there is no way any government could justify the initial investment required.

Over the years it would be interesting to see what the return governments around the globe would receive from the investment in weight loss surgery because there may well be a way to finance it via the private healthcare system – if a significant amount of money can be saved. While the short-term cost of such treatment would be potentially enormous we can only estimate the massive costs which will be encountered by healthcare systems around the world being forced to treat more and more people suffering from diabetes in the future.

When you take into account not only the medical costs but also the cost to employment market, benefits system and also the cost of additional help they may require, the figures just get larger and larger. It may well make sense for governments around the world to target specific areas of the population who they deem to be more at risk of developing type II diabetes. Not only would this impact their lives in the short to medium term but it may well also impact the lives of their children and their immediate family.

Prevention not treatment

Perhaps we have made a simple mistake in targeting the treatment of diabetes type II and diabetes type I when in fact we should be looking to invest more in the prevention of such conditions? While the cost of medical treatment in relation to diabetes will continue to grow in the future it will be staggered over many years and perhaps this is easier to stomach in the minds of voters and politicians rather than investing a significant amount of money today in prevention?

Even though there have been a number of promotional campaigns regarding the issue of diabetes and the potential risks for those in specific categories of the population, the word is just not getting through. The Internet should make a difference, indeed will make a difference, but whether or not it is being fully utilised by the various healthcare authorities and governments around the world remains to be seen.

Conclusion

It will come as no surprise to many people to learn that the connection between obesity, weight loss and diabetes type II in particular is still very strong. However, in the past we have tended to concentrate upon weight loss surgery as a method of controlling type II diabetes as opposed to a method of preventing the onset of the condition. It will be interesting to see whether this very detailed study by Swedish scientist has any impact in the short to medium term because on the surface it could save a significant amount of pain and money in the longer term.
Md Al Faruk
Assistant Professor, Pharmacy