Bariatric Surgery More Effective Than Standard Treatment for Type 2 Diabetes

Bariatric surgery is substantially better at treating individuals with severe type 2 diabetes compared to standard medical therapies, according to a study published in the New England Journal of Medicine.

The researchers found that the majority of study participants who were randomly assigned to receive bariatric surgery were able to cease using diabetes medications and maintained disease remission during the two-year study period. This is compared to 0 participants with the same results in the medical treatment group.

For obese patients with type 2 diabetes, treatment can be challenging since insulin therapy and other hypoglycemic medications can often result in additional weight gain. For this study, the majority of participants saw an improvement in blood sugar levels, improved HDL-cholesterol concentrations, as well as decreased total cholesterol and triglycerides. These results indicate that treating type 2 diabetes with bariatric surgery may lower a patient’s cardiovascular risk.

The researchers conducted the study to determine the rate of diabetes remission in 60 severely obese patients with advanced diabetes. The 60 participants fell into the age range of 30 to 60 years.

The researchers randomly assigned the study participants to one of three groups:
•    One group received Roux-en Y gastric bypass (RYGB)
•    One group was treated with bilopancreatic diversion (BPD)
•    The standard therapy group received a tailored medication treatment and were monitored rigorously

Since beginning the study, no participants in the standard therapy group has gone into remission.
The researchers discovered that diabetes remission occurred and has been maintained 75% of Roux-en Y participants and 95% of patients who underwent bilopancreatic diversion.

Lead author of the study, Dr. Geltrude Mingrone, concludes by stating, "These findings confirm that the effects of bariatric surgery on type 2 diabetes may be attributed to the mechanisms of surgery rather than the consequences of weight loss. Studying the actual mechanisms by which surgery improves diabetes may help understand the disease better."


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