The sausage

By Gareth Rubin

PUBLISHED: 16:00 EST, 13 July 2013 | UPDATED: 16:07 EST, 13 July 2013

It is often a last resort for those desperate to combat their obesity.

Yet doctors are increasingly seeing weight-loss surgery as a way to fight the type 2 diabetes epidemic that has seen the number of British sufferers spiral to more than three million.

It costs the NHS over £9billion a year to treat the disease, which is usually triggered by obesity.

Yet 86 per cent of type 2 diabetes patients who have weight-loss surgery - including gastric bands and bypasses - are in remission from the condition two years later.

The newest option is the gastric sleeve which has many of the benefits of the more invasive bypass.

This involved removing parts of the digestive system, with fewer risks.

Jenny Clarke, 50, from Derbyshire, had a gastric sleeve - known as an EndoBarrier - fitted in September 2011.

The 40-minute procedure, carried out under general anaesthetic, involves a tube being inserted into the mouth and threaded into the stomach and then into the upper intestine.

Once in place, the EndoBarrier - a very thin plastic sheath, similar to sausage-skin - is unfurled and secured with a sprung metal anchor.

It lines the first 2ft of the small intestine, causing food to be absorbed further down the intestine.

Weight loss is one result, but it also inhibits the release of hormones by the gut.

This has a dramatic effect on the function of the pancreas, which regulates production of insulin, the key hormone in diabetes.

Jenny developed the illness after a car accident in 2003. 'I couldn't walk for eight months and was in constant pain. Even though I didn't eat much, I barely moved. Within five years I went from 9½st to 20st.'

The crash had triggered the condition fibromyalgia which causes chronic pain all over the body, and exhaustion. Despite numerous blood tests, doctors failed to spot Jenny's blood sugar reaching alarmingly high levels.

Type 2 diabetes occurs when the body loses the ability to process sugar, with large amounts remaining in the blood which can damage the organs and blood vessels, raising the risk of stroke and heart conditions.

Jenny says: 'My GP ordered test after test which he said showed nothing. My blood sugar was around 19 for two years - about four times above the recommended level.

Then one day he started repeating "Oh my God!" while looking at some results.

I was put straight on to diabetes medication.' Her consultant suggested weight- loss surgery, but Jenny felt the options were too risky.

The most commonly given operation is the gastric bypass which involves cutting the small intestine above the stomach and reconnecting it below, leaving a small pouch for the absorption of some food.

This limits the amount that can be eaten and changes the gut hormones, reducing levels of the appetite stimulant ghrelin and also food preferences, so many patients no longer have an appetite for sweet and fatty foods.

A newer procedure is gastric band surgery - TV presenters Fern Britton and Sharon Osbourne lost weight this way.

It involves an inflatable ring-shaped implant placed around the top of the stomach, slowing the movement of food through the digestive system, restricting the amount that can be eaten.

Jenny's doctor then mentioned the EndoBarrier, which had just been approved.

She had the operation and within six months lost 4st and halved her diabetes medication.

The sleeve was removed last December - it is currently licensed only for use up to 12 months - and her blood sugar has remained normal.

'I was on almost the highest dose of diabetes tablets - now I just take one pill a day.

'The only side effect was that I lost my appetite, and it hasn't returned.

'It cost £7,000 but it was the best option for me.'

The operation is available only privately.

Mr Jamie Kelly, consultant general surgeon at Southampton University Hospital NHS Trust, says: 'I have performed 40 of these procedures and patients have seen significant improvement, if not total remission of type 2 diabetes.'

Even in those who have regained weight, diabetes has generally improved. A

nd a year in remission has substantial benefits in reducing complications from the disease.

Dr David Ashton, of the Healthier Weight clinics, says: 'The positive effects are more profound with surgery than those associated with weight loss alone and they are almost immediate.

'I was sceptical about what happened when the barrier was removed, and whether the effect on insulin is temporary, but the changes may last.'