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'Thousands miss out' on surgery for type-2 diabetes | 'Thousands miss out' on surgery for type-2 diabetes |
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Thousands of people with type-2 diabetes in the UK are missing out on obesity surgery that would slash blood sugars and even lead to remission in some cases, a team of experts say. | Thousands of people with type-2 diabetes in the UK are missing out on obesity surgery that would slash blood sugars and even lead to remission in some cases, a team of experts say. |
Leading surgeon Prof Francesco Rubino described the gut operation as "the closest thing to a cure" available. | Leading surgeon Prof Francesco Rubino described the gut operation as "the closest thing to a cure" available. |
UK guidelines already recommend the surgery for some patients. | |
But experts argue the guidance needs to be expanded and made more prominent, as most doctors do not offer it. | But experts argue the guidance needs to be expanded and made more prominent, as most doctors do not offer it. |
'Biggest changes' | 'Biggest changes' |
About three million people in the UK have type-2 diabetes, which can lead to serious complications, including kidney failure, blindness and heart disease. | About three million people in the UK have type-2 diabetes, which can lead to serious complications, including kidney failure, blindness and heart disease. |
The team predict up to 100,000 obese diabetic patients - including those who are only mildly obese and have already tried medication and lifestyle changes - could benefit from the surgery, which involves removing part of the stomach or re-routing the gut. | The team predict up to 100,000 obese diabetic patients - including those who are only mildly obese and have already tried medication and lifestyle changes - could benefit from the surgery, which involves removing part of the stomach or re-routing the gut. |
But they estimate fewer than 6,000 bariatric operations were carried out for type-2 diabetes last year. | But they estimate fewer than 6,000 bariatric operations were carried out for type-2 diabetes last year. |
They looked at a growing body of evidence that suggests the treatment - traditionally weight-loss surgery - alters gut hormones and the lining of the gut to get blood sugars under control. | They looked at a growing body of evidence that suggests the treatment - traditionally weight-loss surgery - alters gut hormones and the lining of the gut to get blood sugars under control. |
This reduces the need for daily drugs or insulin injections and leads to a period of remission in more than a third of cases, experts say. | This reduces the need for daily drugs or insulin injections and leads to a period of remission in more than a third of cases, experts say. |
Scientists argue the operations - which cost about £6,000 in established centres - would pay for themselves within two years, by cutting the cost of drugs and the expense of treating diabetic complications. | Scientists argue the operations - which cost about £6,000 in established centres - would pay for themselves within two years, by cutting the cost of drugs and the expense of treating diabetic complications. |
They say the National Institute for Health and Care Excellence (NICE) needs to make this option explicit in their diabetes guidance and to expand it to ensure long-term diabetics on the cusp of obesity are also considered. | They say the National Institute for Health and Care Excellence (NICE) needs to make this option explicit in their diabetes guidance and to expand it to ensure long-term diabetics on the cusp of obesity are also considered. |
'Needless barriers' | 'Needless barriers' |
Prof Rubino, co-author of the report and a surgeon at King's College London, said: "Surgery represents a radical departure from conventional approaches to diabetes. | Prof Rubino, co-author of the report and a surgeon at King's College London, said: "Surgery represents a radical departure from conventional approaches to diabetes. |
"The new guidelines effectively introduce, both conceptually and practically, one of the biggest changes for diabetes care in modern times." | "The new guidelines effectively introduce, both conceptually and practically, one of the biggest changes for diabetes care in modern times." |
Meanwhile Prof Mark Baker, at NICE, said the paper appeared to be broadly in line with the updated NICE guideline on obesity. | Meanwhile Prof Mark Baker, at NICE, said the paper appeared to be broadly in line with the updated NICE guideline on obesity. |
But Simon O'Neill at charity Diabetes UK, said: "Many people who stand to benefit from this potentially life-saving treatment are missing out due to needless barriers to obesity surgery services. | But Simon O'Neill at charity Diabetes UK, said: "Many people who stand to benefit from this potentially life-saving treatment are missing out due to needless barriers to obesity surgery services. |
"Even people who meet the criteria for the surgery are made to wait too long." | "Even people who meet the criteria for the surgery are made to wait too long." |
In a joint statement, endorsed by 45 international organisations and published in the journal Diabetes Care, experts put out a global call for surgery to be seen as a standard part of diabetes treatment in certain cases. | In a joint statement, endorsed by 45 international organisations and published in the journal Diabetes Care, experts put out a global call for surgery to be seen as a standard part of diabetes treatment in certain cases. |
The guidelines emerged at a summit organised by charity Diabetes UK, the American Diabetes Association, International Diabetes Federation, Chinese Diabetes Society and Diabetes India. | The guidelines emerged at a summit organised by charity Diabetes UK, the American Diabetes Association, International Diabetes Federation, Chinese Diabetes Society and Diabetes India. |