HIQA recommends Ireland adopts metabolic surgery programme to treat type 2 diabetes

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Conor Teljeur, HIQA Chief Scientist
Dr Conor Teljeur, HIQA Chief Scientist

HIQA has recommended that Ireland should adopt a metabolic surgery programme to treat Type 2 diabetes.

HIQA  Chief Scientist, Dr Conor Teljeur, said  they had submitted recommendations to the Minister for Health and the HSE on introducing a metabolic surgery programme as part of the clinical pathway for treating Type 2 diabetes in Ireland.

HIQA undertook a health technology assessment (HTA) in relation to providing access to metabolic surgery as part of the type 2 diabetes clinical care pathway following a request from the HSE.

It says based on current trends, comorbid type 2 diabetes and obesity will likely increase in Ireland in the coming years. “There is a substantial burden of disease associated with this for both patients and the health service. While international guidelines recommend metabolic surgery to treat patients with Type 2 diabetes and obesity, access to metabolic surgery is not currently available as part of the Type 2 diabetes clinical care pathway in Ireland.

“Our assessment aimed to establish the clinical and cost-effectiveness of using metabolic surgery to treat Type 2 diabetes and obesity. It included reviewing evidence from 24 randomised controlled trials examining metabolic surgery for up to 10 years. It found that metabolic surgery is safe and very effective in patients with comorbid type 2 diabetes and obesity.”

Dr Teljeur,  said, “Overall, we found that providing metabolic surgery as part of the Type 2 diabetes clinical care pathway would be an efficient and highly cost-effective use of healthcare resources. It results in improved blood sugar control, weight loss, and reduced use of anti-hyperglycaemic medications. It is very effective in improving blood sugar control up to 10 years following surgery.

“However, demand for metabolic surgery is difficult to predict as not everyone with comorbid Type 2 diabetes and obesity will want surgery or be a surgical candidate. Furthermore, metabolic surgery is not a one-time intervention and requires ongoing patient support. To ensure successful outcomes for patients, long-term follow-up should be integrated across primary care, community and hospital services.”

These findings will now help to inform decision-making by the Minister for Health and the HSE on treating Type 2 diabetes in Ireland.