Two new studies out this week in the New England Journal of Medicine (NEJM) have found that bariatric surgery may lead to better outcomes for type 2 diabetes patients than medical therapies.
Type 2 diabetes, or adult-onset diabetes, is a chronic disease where you have too much sugar (glucose) in your blood. It usually develops in people who are overweight or elderly. As I wrote earlier this month, diabetes happens when your body has trouble making or using insulin.
One of the studies, out of Italy, compared diabetes patients who'd had standard medical therapy with those who'd had bariatric surgery. Bariatric surgery shrinks the stomach and forces food to skip part of the small intestine, so patients feel full faster and absorb less calories from the food they do eat. The surgery patients stopped taking hypoglycemia pills and insulin within 15 days of the operation. Two years after surgery, they showed 75%-95% remission of diabetes, compared to 0% of the standard medical therapy patients.
The other study, out of Cleveland, compared bariatric surgery patients with those who'd had intensive medical therapy for diabetes. A year after surgery:
- Post-op patients should a significantly reduced reliance on drugs to control their blood glucose levels, compared to the medical therapy patients.
- A much greater percentage of the surgery patients achieved healthy blood glucose levels.
- Surgery patients showed significantly greater sustained weight loss than the non-surgery patients.
Researchers say that bariatric surgery not only improves patient health by helping them lose weight, it also modifies the levels of gut hormones used to metabolize sugars and fats.
An editorial in NEJM predicts these studies will have a major effect on future diabetes treatment, and may urge doctors to recommend bariatric surgery sooner for diabetes patients.
The American Diabetes Association (ADA), however, says the studies will not alter their recommendations. Dr. Vivian Fonseca of the ADA told the New York Times that the studies are too small in sample size to be seen as definitive.
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