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Bariatric surgery in type 2 diabetes could save medication costs

Bariatric surgery in type 2 diabetes could save medication costs

Publication date: Tuesday, 05 July 2016
Contributor(s): Jeremy Bray

A poster at this year’s European Obesity Congress in Gothenburg, Sweden (1-4 June) suggests that bariatric surgery on some obese patients with type 2 diabetes could result in lifetime savings of about £95,000 per patient, mostly due to reduced medication costs.

In this small study, the authors calculated the advantage to the local health economy, based on improvements in blood glucose control following bariatric surgery. Data from 134 patients treated at the Worcestershire Royal Hospital between 2012 and November 2015 were analysed. All patients met NICE criteria for surgery, and had appropriate pre-operative diabetic specialist and dietician input. The researchers also estimated average years of life remaining per patient and used Diabetes UK data on diabetic inpatient and outpatient care to approximate possible savings to the NHS.

Before surgery, 60 of these patients (mean age 48 years, BMI 50 kg/m2 , 76% female) had type 2 diabetes and were receiving a variety of anti-diabetes medications. Following surgery, 44 patients (73%) of these patients no longer required any diabetes treatment (Table), with 11 (18%) having their treatment reduced and only 5 (8%) having no changes to therapy. The authors calculated potential outpatient and inpatient savings of an average of £95,000 per patient over their lifetime.

The authors concluded, “These results are preliminary outcomes from our bariatric service, and we intend to further analyse our data based on longer-term follow-up in the future.”

  Pre op therapy Post op therapy
Oral therapies 52% (31) 13% (8)
Insulin 25% (15) 8% (5)
Insulin + oral therapies 20% (12) 2% (1)
Diet 3% (2) 3% (2)
No treatment 0 73% (44)

Anti-diabetes medications required by patients undergoing bariatric surgery.

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In some cases, bariatric surgery may be a more cost-effective way of managing obese type 2 diabetes patients. 

Chambers S, Manickam D, Wooldridge E et al. Bariatric surgery in type 2 diabetes: the financial impact on the local health economy. Poster P01.238 presented at the European Obesity Summit. 

Topics covered:
Category: Evidence in Practice
Edition: Volume 1, Number 7, BJPCN Online 2016
Contributor(s): Jeremy Bray

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