BARIATRIC SURGERY AND TYPE II DIABETES

A report backed by over 45 international diabetes organisations made waves a few months ago by declaring that invasive surgery might be the future for the treatment of Type II Diabetes. Our dietitian Courtney weighs in on this debate:

The report describes how bariatric surgery should be a standard treatment option for appropriate individuals. Early clinical evidence shows that surgery in some people with type II diabetes may help to improve blood glucose control and reduce cardiovascular disease risk. The surgery isn’t recommended for everyone, according to the report, only type II individuals who are severely obese (BMI of over 35 kg/m2 or more) and are unable to manage blood glucose through traditional means are recommended for the procedure.

Bariatric surgery has often been considered the last resort treatment in the management of morbid obesity. The procedure, costing upwards of $9000 Australian dollars involves reducing the size of the stomach through a gastric band or sleeve, or a portion of the stomach is removed or bypassed. Nine out of ten procedures in Australia are done in private hospitals as it is not currently covered under the Medicare system meaning that many eligible patients do not go ahead with the procedure.

For people living with diabetes, Australian Diabetes Society President Sof Andrikopoulos believes that the strategy should be considered only as an option and ‘not necessarily the first option’ for the management of Type II Diabetes. He emphasised that “diabetes and obesity are lifelong diseases, so we need to consider the impact of diabetes of health and economy in the long term.”

Surgery ignores the need to address overall health and the aspects of modern life that trigger chronic disease like diabetes. If lifestyle factors such as physical exercise and healthy eating are not addressed, then there is a possibility that the number of people developing diabetes will only skyrocket. Upwards of 100,000 people developed type II diabetes last year alone in Australia. Many health professionals believe that the focus on diabetes care should be on prevention and early management if we are to have any hope to curb this pandemic.

Current Australian guidelines recommend a combination of healthy eating, physical exercise and blood glucose monitoring for the management of Type II Diabetes. There is a large body of evidence that shows that early intervention can slow and even reverse early progression of the disease. The Dietitian’s Association Australia recommends that diets should be tailored to the individual in order to obtain long term effects. A diet including low GI carbohydrates, high fibre and low kilojoule foods such as fruits and vegetables and foods low in saturated fat have been shown to be important for weight management as well as for blood glucose control in type II individuals.

It is important to note that whilst advances in the research for diabetes is important, the long term benefits of surgery in the management of the disease is not yet know. What we do know is that by tackling risk factors such as healthy eating and exercise we can improve overall health and well-being as well as helping with the management of type II diabetes. Scientists hope that with renewed interest in diabetes care the possibility of a cure is becoming more likely.

 

Article kindly written by Courtney Norman – A Sydney based Accredited Practising Dietitian.