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Bariatric surgery ‘reduces dependence on diabetes drugs’

By Lilian Anekwe

Performing bariatric surgery on people with type 2 diabetes can reduce patients' dependence on medications and results in lower use of healthcare and costs, according to the results of a large US study.

The results prompted the researchers to recommend GPs and healthcare providers discuss bariatric surgery as a treatment option more readily in obese patients with type 2 diabetes.

A retrospective study of health insurance claims found that the use of diabetes medications fell by 75% in the first six months after bariatric surgery was performed, and overall healthcare costs fell by 60% after three years.

US researchers studied 2,235 adults with type 2 diabetes who underwent bariatric surgery in the US between 2002 and 2005, then used insurance claims data to measure the use of diabetes medications at six, 12 and 24 months after the operation.

At six months 75% of patients were no longer using any diabetes medication, which rose to 81% after one year and 85% after two years. The reductions were observed across all classes of anti-diabetes medication.

After the $30,000 median cost of the surgery, total annual healthcare costs per patient rose by 9.7% the first year after surgery, but then decreased by 34.2% in year two and by 70.5% in the third year.

Dr Martin Makary, director of the Johns Hopkins Center for Surgical Outcomes Research in Baltimore, and lead researcher of the study, published in the Archives of Surgery, said the results supported the theory that the resolution of diabetes is not due to weight loss alone but is also mediated by gastric hormones.

He concluded: ‘Bariatric surgery is associated with a significant reduction in medication-dependent type 2 diabetes with little risk.

‘Obese patients with type 2 diabetes should be counselled regarding the potential benefits of bariatric surgery for the treatment of both obesity and diabetes compared with other options.'

Archives in Surgery. 2010;145(8):726-731

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