Bariatric surgery in patients with diabetes and body mass index less than 35 kg/m2

BlueCross BlueShield Association
Record ID 32013000448
English
Authors' objectives: The overall objective of this Assessment is to determine whether bariatric surgery improves outcomes for diabetic patients with BMI less than 35 kg/m2. A second objective is to determine the comparative efficacy of different bariatric surgery procedures in this population of patients.
Authors' recommendations: Except for gastric bypass, there is insufficient evidence to come to firm conclusions regarding the efficacy of bariatric procedures for diabetes in patients with BMI less than 35 kg/m2. Despite the variation in remission rates between 9 case series, a large proportion of subjects in each study obtain remission of diabetes without medications. Given the natural history of diabetes, it is very difficult to achieve a remission of diabetes with lifestyle and dietary changes. With medication, it is difficult to achieve a level of diabetes control that is otherwise the equivalent of remission in terms of achieved HbA1c levels, lipid levels, and glucose levels. Although the long-term outcomes of gastric bypass in terms of occurrence of complications of diabetes has not been directly observed, knowledge of long-term outcomes of gastric bypass in the morbidly obese make it likely that the improvement of diabetes status is durable and patients' health outcomes will improve. Gastric bypass is a well-established procedure for the morbidly obese, in whom the risk/benefit profile has been deemed acceptable for appropriately selected morbidly obese subjects. The risk/ benefit profile for diabetic subjects is likely to be similar.
Details
Project Status: Completed
Year Published: 2012
URL for published report: http://www.bcbs.com/blueresources/tec/vols/27/27_02.pdf
URL for additional information: http://www.bcbs.com/blueresources/tec/vols/27/bariatric-surgery-in-patients.html
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: United States
MeSH Terms
  • Blue Cross Blue Shield Insurance Plans
  • Body Mass Index
  • Technology Assessment, Biomedical
  • Treatment Outcome
  • United States
  • Weight Loss
  • Bariatric Surgery
  • Diabetes Mellitus
  • Obesity
  • Remission Induction
Contact
Organisation Name: BlueCross BlueShield Association
Contact Address: BlueCross BlueShield Association, Technology Evaluation Center, 225 North Michigan Ave, Chicago, Illinois, USA. Tel: 888 832 4321
Contact Name: tec@bcbsa.com
Contact Email: tec@bcbsa.com
Copyright: BlueCross BlueShield Association (BCBS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.