Increasing Awareness and Consideration of Bariatric Surgery Treatment Option in Obese Type 2 Diabetes Mellitus Patients
Abstract
**Please note that the full text is embargoed** ABSTRACT: Background:
Current research indicates the efficacy of bariatric surgery (BS) in the treatment of obese Type 2
Diabetes Mellitus (T2DM) patients, but only a few actually get this treatment option. This is
evident when a comparison of the prevalence of T2DM and obesity is compared to the actual
number of surgeries conducted. The American Society of Metabolic and Bariatric Surgery
(ASMBS) states that less than 1 % of eligible patients (general) have access to BS. The option
most frequently considered to manage obesity and T2DM (i.e. lifestyle modification), is
ineffective and results in weight regained in an average of 4 years.
Method/Data source:
The purpose of this quality improvement project was to increase provider awareness regarding
BS for the treatment of obese individuals with T2DM. An evidence based protocol was
implemented that included offering information and the option of BS to treat adult obese patients
with T2DM. Documentation of patient education regarding BS was obtained from a random
sample of medical records pre and post intervention.
Results:
Forty-four (44) and forty-one (41) charts were reviews pre and post intervention respectively.
Pre-intervention none of the charts reviewed had evidence of documentation of BS as a treatment
option. Post intervention 83% (34/41) of the charts had BS education documented. Of the
patients offered the BS option 56% (19) opted for BS. Of the 44% (15) who refused, more than
half (8) was due to the fear of surgery. Of note is that the diagnosis of obesity was not
documented in 80% of the charts reviewed pre-intervention and post-intervention 49% of the
charts reviewed did not have obesity as a listed diagnosis.
Conclusion and implications:
Current evidence shows BS results in significant improvement of T2DM, compared to current
medical therapy with lifestyle modification. Despite this evidence, the option of BS is often not
included in provider patient education. This QI project suggests that if patients are given the
option more than half of the patients will consider BS as their treatment option. Based on the
epidemic nature of T2DM, increased awareness is necessary among clinicians for the
consideration of BS to treat obese T2DM patients, and help improve patient access.