Among obese patients who underwent bariatric surgery 40% achieved at least partial remission of type 2 diabetes mellitus, compared with no patients who underwent a nonsurgical lifestyle intervention program, investigators reported online July 1 in JAMA Surgery. Participants who were placed into groups that involved surgery either had a Roux-en-Y gastric bypass or had adjustable gastric banding.
The researchers conducted the analysis using a set of independent variables among the participants in the study, including age, sex, body mass index (BMI), diabetes status and degree of obesity; as well as some key dependent variables, such as the proportion of weight loss, change in diabetes status score and percent changes in fasting sugar and glycosylated hemoglobin.
In the trial, 61 obese adults with diabetes were randomly assigned to one of two surgical procedures or intensive lifestyle intervention and followed for three years.
Obese patients are often diagnosed with type 2 diabetes, and losing weight may help lessen the symptoms of this condition. The third had a non-surgical intensive weight loss program in year one, followed by the less-intensive lifestyle program used with the other groups.
After analyzing all of the data collected from these variables, the researchers concluded that with the adjustable gastric band, weight loss is the fundamental mechanism for optimization of diabetes.
With gastric bypass surgery, surgeons reduce the size of the stomach similar to that of a small pouch.
In terms of type 2 diabetes, researchers found there was more improvement in the surgical groups than in the lifestyle-only treatment group. No remission was seen in the nonsurgical group.
All patients received guidance for healthy lifestyle changes during the last two years of this study.
“But the three-year results are certainly very exciting”, said Courcoulas.
This research was supported by the National Institute of Diabetes and Digestive and Kidney Diseases and the Magee-Womens Hospital of the University of Pittsburgh Medical Center. These can include bleeding, infection and blood clots that can travel to the lungs, according to NIDDK.
When diabetes returns, it has to be treated. Patients who were treated with weight loss surgery will need “fewer medications and are easier to treat” in the future.
Losing weight through surgery is more effective at holding off diabetes for obese people compared to exercising and dieting alone, a new study says.
“There is a predictable rate of mortality and documented morbidity with these surgeries, and all have perioperative and postoperative complications”, said Garvey, who is a spokesperson for the American Association of Clinical Endocrinologists (AACE) and chairs the association’s Obesity Scientific Committee.