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Long-term diabetes control better with surgery than standard therapy
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More effective control of type 2 diabetes in patients was found with metabolic or bariatric surgery compared with standard medical treatments, according to recent study findings published in The Lancet.
“The ability of surgery to greatly reduce the need for insulin and other drugs suggests that surgical therapy is a cost-effective approach to treating type 2 diabetes,” Francesco Rubino, MD, chair of bariatric and metabolic surgery at King’s College London, said in a press release.
Francesco Rubino
Geltrude Mingrone, MD, professor of diabetes and nutrition at King’s College London, Rubino and colleagues evaluated 60 adults aged 30 to 60 years with a BMI of 35 kg/m2 or more and a history of type 2 diabetes for at least 5 years who were randomly assigned to medical treatment (n = 20), gastric bypass surgery (n = 20) or biliopancreatic diversion (n = 20). Follow-up was conducted for 5 years, and 53 patients completed the follow-up period.
After 5 years, no patients in the medical treatment group had diabetes remission compared with 19 of 38 patients in the surgery groups; particularly, 37% in the gastric bypass group and 63% in the biliopancreatic diversion group had remission.
HbA1c levels of 6.5% or lower were found in 42% of patients who underwent gastric bypass and 68% who underwent biliopancreatic diversion vs. 27% of those medically treated.
Both surgical groups experienced greater weight loss compared with the medically treated group; however, there were no significant differences in weight loss between them.
Cardiovascular risk, total cholesterol, LDL cholesterol and triglycerides were all reduced among patients in the surgical groups.
“The lower incidence of typical diabetes complications in this study is in line with previous findings from long-term nonrandomized studies; however, larger and ideally multicenter randomized trials are needed to definitively confirm that surgery can reduce diabetes morbidity and mortality compared to standard medical treatment,” Mingrone said in the release. “Nevertheless, surgery appears to dramatically reduce risk factors for [CV] disease.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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