Furthermore, 80 per cent of surgery patients maintained optimal blood glucose control despite only taking one anti-diabetes medication or nothing at all, according to Professor Francesco Rubino.
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Patients also reported an improvement in their overall quality of life.
“The ability of surgery to greatly reduce the need for insulin and other [diabetes] drugs suggests that surgical therapy is a cost-effective approach to treating type 2 diabetes”, Rubino said in a news release from the college, where he is chair of bariatric and metabolic surgery. Dr. Schauer did not participate in the new study. For example, a study published in July in JAMA Surgery, of 61 obese people with type 2 diabetes, found that weight-loss surgery was better at keeping the disease at bay compared to diet and exercise alone.
All of the study groups had a reduction in cardiovascular risk. Now in a new study, a group of researchers took on the longest-term study ever performed to determine which of the above-mentioned interventions is better.
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. Also, patients who had weight-loss surgery were less likely to have diabetes-related complications such as heart attack, stroke and kidney disease.
“The ultimate question is whether diabetes surgery is associated with reduced mortality”.
Now the National Institutes of Health states that patients should have a BMI of 40, or a BMI of 35 with obesity-related illness, such as type 2 diabetes, in order to be eligible for weight loss surgery.
In the end, the researchers concluded that surgery is more effective than administration of medications in controlling obese individuals diagnosed with type 2 diabetes. Twenty study subjects were assigned to each treatment procedure, which includes medication, gastric bypass and biliopancreatic diversion.
Patients randomly underwent one of two types of bariatric surgery – gastric bypass and biliopancreatic – or continued with conventional medical therapy to control their type 2 diabetes.
“What really is causing the remission of diabetes after surgery remains mysterious”, Dr. Rubino said. “And, that the procedure is relatively safe with a very low complication rate”.
Meanwhile Professor Geltrude Mingrone, co-author of the study and professor of Internal Medicine at the Universita Cattolica in Rome said that larger trials need to be undertaken to confirm weight loss surgery’s effectiveness compared to drugs.
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He also says, “Physicians should strongly consider surgery as an important option for long-term control of diabetes”. “This study is going to make insurance carriers and third party payers rethink their coverage policies regarding bariatric or diabetes surgery, as we prefer to call it”.
