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15 April 2011

First National Bariatric Surgical Registry report shows surgery reduces type 2 diabetes

The latest report published by Dendrite Clinical Systems shows that on average patients lost nearly 60% of their excess weight and type 2 diabetes was resolved in 50% of the patients who previously had the condition, a year after surgery.

The 'First National Bariatric Surgery Report" is the first publication from data collected by the National Bariatric Surgery Registry (NBSR). The NBSR is the result of a unique collaboration between ALSGBI (Association of Laparoscopic Surgeons of Great Britain and Ireland), AUGIS (Association of Upper Gastrointestinal Surgery), BOMSS (British Obesity & Metabolic Surgery Society) and Dendrite Clinical Systems, and was created to accumulate weight loss, co morbidity and quality of life data following surgery. Out of an estimated 10,000 such operations carried out in the UK during the financial years 2008/09 and 2009/10, the audit collected data from 7,045 bariatric operations.

This first report features data from some 86 UK hospitals includes detailed one-year follow up data from 1,421 procedures, carried out between 1 April 2008 and 31 March 2010. From the procedures reporting follow up data, 379 patients had type 2 diabetes before surgery, while one year later that figure had fallen to 188, and after two years 86% of those with diabetes prior to surgery had no indication of the disease (i.e. were able to stop their medications).

The report also noted that bariatric surgery was safe as the observed in-hospital mortality rate after primary surgery was 0.1% overall, with a surgical complication rate of 2.6 %. Most patients (80%) were discharged by the third post-operative day. The authors say that their results provide evidence that bariatric surgery is one of the most clinically effective, safe and cost-effective treatments available to the NHS.

"An approach that limits treatment to a fraction of those who would benefit is one which the NHS will rue in years to come as these patients become an unsustainable burden on the health service,” Dr Alberic Fiennes, a Chairman of the NBSR Data Committee and past-President of BOMSS, said the treatment should be made more widely available on the NHS. "Prevention strategy alone has proved ineffective; there are at least two generations of morbidly obese patients who are now presenting with diabetes, stroke, heart disease and cancer for whom preventative measures are utterly irrelevant. The numbers are increasing, these people need to be treated."

The report also states that around two-thirds of severely obese patients had three or more associated diseases by the time they reached surgery including 32% with hypertension and 17% with high cholesterol. One year after surgery, patients reporting with hypertension and high cholesterol had dropped to 20% and 8%, respectively,

The authors of the report claim the cost of bariatric surgery (approximately £10,000) is recouped within three years as obesity associated costs are eliminated. It says there are about 1 million people in the UK who could benefit from bariatric surgery and the NHS could regret limiting treatment.

"Surgeons have been saying for years that the NHS is on the brink of being swamped by obesity related referrals,” said John Black, President of the Royal College of Surgeons. "Rather than hoping the situation will miraculously disappear, it is time that the Department of Health acknowledges the problem and works with us to develop a long-term plan to meet increased demand."

To view an extract or purchase the First National Bariatric Surgery Registry Report, please click here.

National Bariatric Surgery Registry Report in the news:

BBC News

The Guardian