Surgery may hold answer to diabetes

With Type 2 highly prevalent in the UAE, doctors are hopeful that expanding their treatment options may bring success.

Dr Job Simon, endocrinologist at Burjeel Hospital, says metabolic surgery may help those with early-stage diabetes. Mona Al Marzooqi / The National

ABU DHABI // A surgical procedure to treat Type 2 diabetes could soon be available in the UAE.

Doctors were hopeful that metabolic surgery may help to reverse the effects of the disease, but cautioned that it was too soon to think of it as a cure in all cases.

International diabetes organisations, including the American Diabetes Association, recommended this form of surgery to treat Type 2 diabetes in patients with a body mass index (BMI) of more than 40 and in some cases in those as low as 30.

“Surgery shows that operating on the gut is the most effective and most powerful intervention to diabetes, which has always been considered progressive and irreversible,” said Prof Francesco Rubino, chairman of metabolic and bariatric surgery at the diabetes and nutritional sciences division at King’s College Hospital in London.

“Many patients who have surgery can go into a state of prolonged remission and some even for life. This mean diabetes is no longer to be considered irreversible,” he said.

“From being a disease treated by medication, diabetes becomes a disease that can also be treated by surgery. Conceptually, this is one of the biggest revolutions for diabetes and an amazing advance.”

Prof Rubino, who is patenting the procedure, said the surgery may never be a “mass therapy” as it was difficult to carry out on millions of people.

An estimated 34 million people live with Type 2 diabetes in the Mena region and about 19 per cent of the UAE’s population is diagnosed.

The average global figure is 8.3 per cent.

“Kings College is putting together this project in the Emirates and this is one of the disciplines that we want to develop,” Prof Rubino said.

Dr Job Simon, a consultant endocrinologist at Burjeel Hospital, said metabolic surgery seemed to help those with early-stage diabetes.

“If the surgery is done in the first five years of a person getting diabetes, the chances of remission are more. Remission doesn’t happen for people who have had diabetes for a long time,” said Dr Simon.

He did not believe that there was enough data to prove surgery on patients at the lower scale of obesity was effective.

Dr Simon said the chances of diabetes remission were greater with a gastric bypass than with other procedures, such as a sleeve gastrectomy, although there was no guarantee of success.

“It’s worth a thought, but an oversimplification. Not everyone goes into remission.”

Some studies showed that a very low calorie diet could also achieve diabetes remission, Dr Simon said.

“If you’re a young, healthy person who gets diabetes, exercising and eating a low-calorie diet can help you can achieve remission.”

Dr Alaeddin Saghir, an endocrinologist based at B R Medical Suites in Dubai Healthcare City, said not all Type 2 diabetes-patients could be referred for surgery.

“If the patient’s BMI is more than 40, we can get rid of about 40 kilos, and in most cases we see a cure of Type 2 diabetes. Bariatric surgery can partially or totally treat diabetes,” said Dr Saghir. “Sometimes the result is not sure.”