Response of Type II Diabetes Mellitus to the Preoperative Liquid Diet as a Predictive Model for Diabetes Resolution in Bariatric Surgery Patients

Introduction: Type II is the most common type of Diabetes Mellitus, and one of the most common non-communicable diseases globally. In Indonesia, diabetes contributes to 6% of total deaths. Current medicaments therapy available can only control the disease, not to cure it. Recently, there has been new treatment that has been recommended into standard care for type II Diabetes Mellitus. It was in September 2015 at the second Diabetes Surgery Summit that the introduction of bariatric surgery has been put into standard care for type II Diabetes Mellitus.Objective: To draw a comparison of the effectiveness between bariatric surgery and current medicaments therapy in reducing HbA1c to achieve remission.Methods: Literature study was conducted to identify relevant literature showing comparison study between bariatric surgery and medicaments therapy, and comparison study between types of bariatric surgery. 16 Studies are included in this article from 230 studies found.Results: HbA1c remission in bariatric surgery is significantly higher than medicaments therapy in all studies, ranging from 66.7% vs 0% to 57.1% vs 9.5% during 6-24 months after therapy. Between all types of bariatric surgery, most of the studies shows that Roux-en-Y Gastric Bypass achieves HbA1c remission higher than other types of surgery.Conclusion: Bariatric surgery is better than current medicaments therapy in achieving HbA1c remission.

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Cost-effectiveness of Bariatric Surgery: Increasing the Economic Viability of the Most Effective Treatment for Type II Diabetes Mellitus

The American Surgeon ◽

10.1177/000313481508100820 ◽

2015 ◽

Vol 81 (8) ◽

pp. 807-811 ◽

Cited By ~ 16

Author(s):

Jeremy A. Warren ◽

Joseph A. Ewing ◽

Allyson L. Hale ◽

Dawn W. Blackhurst ◽

Eric S. Bour ◽

...

Keyword(s):

Diabetes Mellitus ◽

Bariatric Surgery ◽

Cost Effectiveness ◽

Type Ii Diabetes ◽

Cost Savings ◽

Medical Costs ◽

Type Ii Diabetes Mellitus ◽

Morbidly Obese ◽

Type Ii ◽

The Cost

There has been considerable debate on the cost-effectiveness of bariatric surgery within larger population groups. Despite the recognition that morbid obesity and its comorbidities are best treated surgically, insurance coverage is not universally available. One of the more costly comorbidities of obesity is Type II diabetes mellitus (T2DM). We propose a model that demonstrates the cost-effectiveness of increasing the number of bariatric surgical operations performed on patients with T2DM in the United States. We applied published population cost estimates (2012) for medical care of T2DM to a retrospective cohort of morbidly obese patients in South Carolina. We compared differences in 10-year medical costs between those having bariatric surgery and controls. Resolution of T2DM in the bariatric cohort was assumed to be 40 per cent. Considering only the direct medical costs of T2DM, the 10-year aggregate cost savings compared with a control group is $2.7 million/1000 patients; the total (direct and indirect) cost savings is $5.4 million/1000 patients. When considering resolution of T2DM alone, increasing the number of bariatric operations for a given population leads to a substantial cost savings over a 10-year period. This study adds to the growing body of evidence suggesting that bariatric surgery is a cost-effective means of caring for the obese patient.

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