Weigh-Loss Surgery For Children
NHS Choices, 3rd March 2009
Experts say obese children should be given possibility to beat diabetes by undergoing gastric banding procedure. Also paediatricians are of the opinion that more radical treatment in this matter is needed from NHS, otherwise the children will suffer serious health problems in the future.
In the recent studies a group of 73 teenagers took part. The studies were carried out by Dr. J. Shields and colleagues from the Royal College of Paediatrics and Child Health in London, the University of Birmingham, the University of Bristol and the Bristol Royal Hospital for Children. All patients had type 2 diabetes and were treated in a variety of ways, such as medicines, diet, physical exercise to lose weight and diabetes. Many patients gained weight rather than lost it which shows ineffectiveness of the treatment.
Weigh-loss procedure was not object of the research. Only one obese child, who failed medical treatment, waited for the operation.
Initially, the patients went through monthly surveillance of paediatricians. They were carried out by the British Paediatric Surveillance Unit to identify cases of diabetes.
Information about diabetes was collected: the type of diabetes, details of diagnosis, family history, BMI (body mass index), etc. A year later a questionnaire with questions about insulin, blood glucose, height, weight and comorbidity was sent.
In the report the information about the weight, height and blood pressure was included, and how they changed over the year.
At the beginning of the research, the average age of the patients was 13.6 years. The average BMI was 32.5.
A year afterwards, the patients gained an overage 3.1 kg. 67% of the teenagers managed to reduce their BMI. Only 11 children (15%), though, managed to lose some weight.
At the beginning of the study 47% of the patients were treated with Metformin, while 17% changed diet and lifestyle. A year later, only 8% of the children continued the diet, whereas 61% started receiving Metformin.
No improvement in the BMI was reported with the group who kept diet. Only 58% of the adolescents improved their blood glucose level.
The report of the study says that the BMI does not improve much after the medical treatment of the type 2 diabetes and that “overall change in BMI in the group was disappointing, given that lifestyle modification is central to the management of type 2 diabetes.
According to the researchers, the study shows weaknesses in the way children with diabetes are treated in the UK. Also “given the increasing prevalence of type 2 diabetes in paediatric practice, these poor weight-management figures and evidence of poor metabolic control indicate an urgent need to develop specific strategies to deal with this relatively new patient group”. These strategies should feature “culturally sensitive lifestyle and behaviour changes as the cornerstone of therapy”.
