Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2016

The changing management of type 2 diabetes - metabolic/bariatric surgery in Western Sydney (#266)

Carolyn Jameson 1 2 , John Leyden 1 , Henry Pleass 1 3 , Brendan Ryan 1
  1. Sydney Bariatric Clinic, Westmead, NSW, Australia
  2. Kolling Institute of Medical Research, St Leonards, NSW, Australia
  3. Dept of Surgery, Westmead Hospital University of Sydney, Sydney, NSW, Australia

The number of adults, with diabetes worldwide, quadrupled to over 400 million between 1980 and 2014.1 Type 2 diabetes (T2DM) is the fastest growing chronic disease in Australia, associated with cardiovascular disease, stroke, blindness, renal failure, neuropathy, amputations, impotency, depression, cognitive decline, malignancy, significant mortality and costs our health system almost $15 billion each year. 

Research, including a number of RCTs, over the past decade, has shown less than half of patients with T2DM are able to control their blood glucose levels by changing diet, participating in exercise or taking medication. Conversely, multiple clinical trials have shown metabolic surgery to be safe, able to improve blood glucose levels more effectively than lifestyle or pharmaceutical interventions and lead to long term remission and improvement in diabetes in almost all cases. Furthermore, economic analyses suggest costs of surgery may be recouped within 2 years through reduced spending on medical care.2 The recent joint statement by international diabetes organisations recommends inclusion of metabolic surgery in the treatment algorithm for T2DM.3 Current NH&MRC guidelines recommend bariatric surgery be considered for people with BMI >30kg/m2 who have poorly controlled T2DM and are at increased cardiovascular risk.

Sydney Bariatric Clinic is a high volume, metabolic/bariatric surgery multidisciplinary clinic, based in Western Sydney, an area with a high prevalence of diabetes amd obesity. We will present our pre- and post-operative data which shows significant improvements in fasting insulin and blood glucose parameters in our patient population group.

 

  1. Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4·4 million participants. NCD Risk Factor Collaboration. Lancet. 2016;387(10027):1513–1530
  2. Economic impact of the clinical benefits of bariatric surgery in diabetes patients with BMI 35kg/m2. Klein S, Ghosh A, Cremieux PY, Eapen S, McGavock TJ. Obesity. 2011;19:581–587
  3. Metabolic surgery in the treatment algorithm for type 2 diabetes: A joint statement by international diabetes organizations. Cefalu WT, Rubino F, Cummings DE. Diabetes Care. 2016;39(6):861–877