Hiqa looks at gastric bypass as treatment for type 2 diabetes

Hiqa looks at gastric bypass as treatment for type 2 diabetes

The Health Information and Quality Authority (HIQA) has commenced work on an assessment of metabolic surgery for the treatment of type 2 diabetes (T2D) and obesity. Photo: Sasko Lazarov/Photocall Ireland

The health watchdog is exploring whether bariatric or metabolic surgery could be used for the treatment of obesity and type 2 diabetes in Ireland.

The Health Information and Quality Authority (Hiqa) is examining whether bariatric surgery — the modification of the stomach and intestines in what is also known as a gastric bypass — could be used in treating the conditions.

In Ireland, type 2 diabetes is currently treated with anti-hyperglycaemic medications and insulin therapy, in addition to lifestyle changes such as diet and exercise.

Dr Conor Teljeur, Hiqa’s chief scientist said the benefits of metabolic surgery are not limited to weight loss as surgery may have additional benefits for people with type 2 diabetes.

In Ireland, it is estimated that 160,000 people have type 2 diabetes, with obesity being the most important modifiable risk factor. 

The aim of this assessment is to establish the clinical- and cost-effectiveness of metabolic surgery for the treatment of type 2 diabetes and obesity in Ireland.

A number of international diabetes associations, including the American Diabetes Association (ADA) and the International Diabetes Federation (IDF), recommend metabolic surgery in the clinical care pathway for type 2 diabetes.

Effective treatment options 

The assessment will also estimate the budget impact, organisational and resource implications associated with introducing a metabolic surgery programme and the outcome will be provided as advice to the Minister for Health to inform a decision on introducing a metabolic surgery programme, in addition to existing bariatric surgery services in Ireland.

Obesity and type 2 diabetes are both significant public health concerns in Ireland and elsewhere and obesity increases the risk of developing type 2 diabetes which can lead to long-term complications.

“It is important that effective treatment options are available for patients with both type 2 diabetes and obesity to reduce the burden of disease on the healthcare system," Dr Teljeur said.

“Surgery may have additional benefits for people with type 2 diabetes such as improvements in blood sugar control.

This assessment will consider whether or not metabolic surgery should be incorporated into the clinical care pathway for type 2 diabetes in Ireland.

Hiqa has established an expert advisory group comprising representatives from key stakeholder groups who will advise the HTA evaluation team during the course of the assessment.

The HTA is scheduled to be finalised in early 2022.

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