Surgical weight loss – improves diabetes, is cost-effective ?

ARIZONA – A recent clinical trial (April 2009) has demonstrated a successful strategy for treating type 2 diabetes in obese individuals. Weight loss surgery is known to effectively induce weight loss and now it appears it can also help in the management of diabetes type 2.

The Australian study originally reported in the medical journal, Diabetes Care, showed that “surgically induced weight loss leads to the remission of type 2 diabetes in the majority of obese patients,” according to Catherine L. Keating, MPH, the lead author out of Monash University.

The trial included 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. A closer look at the data demonstrated that remission of diabetes was achieved in 22 patients (73 percent) treated surgically and 4 patients (13 percent) treated medically.

Using data, the researchers estimated the costs and benefits of weight-loss surgery as a way to treat type 2 diabetes. They calculate that over a two-year period, the cost of resolving one case of diabetes was $25,500 with medical treatment, and $16,600 more than with surgical therapy (Source: Foxnews.com).

According to the authors, “compared to conventional therapy, surgically induced weight loss was actually associated with health care savings, as well as with health benefits”. Specifically, “this analysis suggests that after 10 years the return on investment of surgical therapy is fully recovered through savings in health care costs.”

While this is a very interesting study that has, in my opinion, some very serious limitations. The most important includes the limitations of gastric banding in establishing long-term weight loss. It is known that a large proportion of patients can gain a most of the initial weight loss after some years. To extrapolate the data to 10 years given these limitations is not realistic.

While this study may point us in the right direction, the only way to validate the results of this clinical trial with regards to the remission of diabetes type 2 via gastric banding and the potential costs-savings will be to have a new study that follows the patients prospectively for 10 years. The trial should include a larger numbers of patients.