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Surgery ‘safe and effective’: diabetes experts

December 20, 2011
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Anne Binns has no regrets over lap band surgery she underwent two years ago; her diabetes has cleared up and she is healthier than ever.

Anne Binns has no regrets over lap band surgery she underwent two years ago; her diabetes has cleared up and she is healthier than ever. Photo: Luis Enrique Ascui

AUSTRALIA’S worsening diabetes epidemic could be reduced dramatically by more publicly funded gastric banding surgery – a treatment shown to put most people into remission, experts say.

While bariatric surgery has generally been considered a last resort for the severely obese, diabetes specialists are now saying people with mild to moderate obesity should consider it if they fail to lose weight with conventional methods.

Director of International Research at the Baker IDI Heart and Diabetes Institute, Professor Paul Zimmet, said the International Diabetes Federation recently released a statement backing bariatric surgery as an option for patients with a body mass index over 30 because of the limited range of therapies available to treat type 2 diabetes.

To make matters worse, Professor Zimmet, a member of the federal government’s preventative health taskforce, said many people found themselves on an increasing range of medications as their diabetes progressed, including some that led to weight gain, exacerbating their condition.

This problem, combined with studies showing gastric banding surgery to be effective at putting up to 73 per cent of type 2 diabetes patients into remission, had made surgery more appealing for doctors, he said.

While gastric banding procedures have become safer over the past decade, Professor Zimmet said many doctors did not discuss it with patients, meaning less than 1 per cent of those eligible were considered for the surgery. Only some public hospitals offer the procedure to a small number of patients, and in a private hospital it costs about $4000 for those with health insurance or $12,000 for those who pay up front.

”I think state governments need to make it more accessible for people where it’s indicated,” he said.

About 1.5 million Australians are estimated to have type 2 diabetes, costing the nation about $12 billion each year, and one in five adult Australians is predicted to have the condition by 2025 if governments do not intervene to prevent more diagnoses.

Professor Paul O’Brien, one of the pioneers of gastric banding surgery in Australia, said he believed the procedure warranted more government funding because it had been shown to be cost-effective and safe, with the risk of death now one in 2000 – similar to a gall bladder removal. He said most of the estimated 12,000 procedures being done each year were done privately, with people waiting years to be considered for the surgery in public hospitals.

However, obesity and diabetes researcher at RMIT University, Associate Professor Jeff Walkley, said surgery should not be viewed as a silver bullet because it required lifestyle changes to work as well. He said people considering the surgery should also seek a second opinion because many doctors, including Professor O’Brien, received funding from gastric band manufacturers for their research.

Professor O’Brien, director of Monash University’s Centre for Obesity Research and Education, says this has not compromised his research in any way.

Anne Binns, 55, of South Yarra, said she was thrilled with the results of a stomach band she had implanted two years ago after being diagnosed with type 2 diabetes. Within a year, she had lost 17 kilograms, had a healthy BMI of 22 and no longer had diabetes.

”I’ve found it to be brilliant,” she said.

Article source: http://www.theage.com.au/national/surgery-safe-and-effective-diabetes-experts-20111219-1p2ex.html

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