In a nutshell
This study investigated if combining bariatric surgery with medical therapy was more effective in treating type 2 diabetes in obese patients.
The authors concluded that bariatric surgery in combination with medical therapy was more effective in improving diabetes symptoms in these patients.
Some background
Bariatric surgery is a procedure usually performed to aid weight loss. It involves either removal of a portion of the stomach (sleeve-gastrectomy) or reducing its size (gastric bypass). This can also improve cardiovascular (heart and circulation) risk factors.
Bariatric surgery may also be effective in the treatment of type 2 diabetes. Studies have shown that surgery in combination with medication to regulate blood sugar levels can improve diabetes symptoms more than medication alone. The long-term effectiveness of this treatment combination is still unclear.
Methods & findings
134 people with type 2 diabetes and a body mass index (BMI) of 27-34 were included in the study. Patients were randomized into three treatment groups. One group received medication only; the other groups also underwent either gastric bypass or sleeve-gastrectomy. Patients were assessed after a 5-year period.
5% of patients treated with medication reached an HbA1c (average blood glucose over 3 months) of less than 6%, compared to 29% of gastric bypass and 23% of sleeve-gastrectomy patients. More patients who underwent surgery (89%) no longer required insulin to maintain blood sugar control after 5 years. This was compared to 61% of those who did not undergo surgery. Patients who underwent surgery also had greater reductions in BMI and blood pressure, and greater improved kidney function and quality of life.
The bottom line
This study concluded that bariatric surgery, in combination with medication, may improve long-term disease management in obese patients with type 2 diabetes.
The fine print
The number of patients included in this study is small and larger studies are needed to confirm these findings.
What’s next?
If you have any questions regarding bariatric surgery as a treatment option for type 2 diabetes please discuss this with your physician.
Published By :
The New England Journal of Medicine
Date :
Feb 16, 2017
