August 2015 | Lúnasa 2015

Reversing End Organ Damage Through Diabetes Surgery

Tue, 25 August 15 10:44

World renowned experts in the field of diabetes met in UCD Conway Institute on  24th August, is association with Irish Society for Clinical Nutrition and Metabolism, to discuss radical new interventions in the treatment of diabetes. The Conference, entitled ‘Revising end organ damage through diabetes surgery’, was chaired by UCD Professor, Carel la Roux and highlighted the possibility of a newly defined discipline, diabetes surgery, being used more widely to treat the most severe of diabetes cases. 

Diabetes is one of the most serious health issues being tackled in Ireland, currently affecting more than a quarter of a million people. The cost of diabetes is over €730 million annually with over 60% of this being spent treating the complications of diabetes. Up to 30,000 adults are unaware that they have diabetes, less than 25% of whom manage to meet targets to control their blood sugar level. Inappropriate nutrition can exacerbate the condition which then leads to complications involving the eyes, kidneys, nerves, circulation and heart. 

Professor Francisco Rubino, Chair of Metabolic and Bariatric Surgery, King’s College London said;

I believe the association between obesity and diabetes are not causally linked. Diabetes can be improved by weight loss independent mechanisms which diabetes surgery can provide.

Surgery that can address diabetes is becoming more widespread in Ireland with procedures available in the public sector at St. Vincent’s University Hospital and Galway University Hospital; they are also available privately in Bons Secours and Galway Clinic. However, Ireland has the lowest number of procedures in both the public and private sector of any European country.

Speaking on the cost of surgical intervention, Professor Carel Le Roux, of the UCD Diabetes Complication Research Centre, and conference Chair said:

When speaking about surgical intervention it may seem drastic at first, however the benefits to both the patient and to the healthcare budget are significant. One year of dialysis for one patient, which many diabetes patients need due to complications from the disease, costs €60,000. Therefore, if we use a €10,000 operation to prevent someone going onto dialysis then the budgetary impact of doing surgery is positive.

Professor Le Roux was keen to point out that this would not be an overnight solution, but surgery today would be more cost effective in the long run:

It would take up to two years before you would start saving money on a patient’s treatment.  However after that point the direct healthcare cost of patients with complications associated with diabetes can be significantly reduced to the point where it pays for the intervention and we would start saving money.

Although treatments have come a long way in recent years, many patients cannot control their disease properly. Even with medication, good nutrition and exercise, life-threatening complications such as severe organ damage can arise. If a surgical option in the treatment of diabetes becomes more widely recommended, it will completely change how the disease is currently managed.