Bariatric Surgery Better Than Drugs Alone for Obese T2DM Patients
Patients who underwent surgical procedures had a greater mean percentage reduction from baseline in glycated hemoglobin level than did patients who received medical therapy alone.
(HealthDay News) — Five years after bariatric surgery, patients with type 2 diabetes who have the procedure show better improvements in quality of life and overall health, compared with those who only take diabetes medications, according to a study published in the New England Journal of Medicine.
Philip Schauer, MD, director of the Cleveland Clinic Bariatric and Metabolic Institute, and colleagues followed 150 obese patients with type 2 diabetes who were randomly assigned to medication alone or to medication plus bariatric surgery (Roux-en-Y gastric bypass or sleeve gastrectomy). Five years later, the researchers looked for reductions in glycated hemoglobin and whether patients could stop taking their diabetes medications.
The investigators found that among the patients who completed the study, 2 of the 28 patients assigned to medical treatment alone were able to stop their diabetes medications (5%). This compared with 14 of the 49 patients who had gastric bypass surgery (29%), and 11 of the 47 patients who underwent sleeve gastrectomy (23%). Patients who had bariatric surgery also had lower glycated hemoglobin than patients treated with medication alone. Patients who underwent surgery lost significantly more weight and had dramatically lower triglycerides and cholesterol than those who were treated with medication alone. No major late surgical complications were reported, except for one reoperation.
"Surgery has come as close as any treatment that we know of that can lead to long-term remission of type 2 diabetes, which is about as close to a cure as you can get," Schauer told HealthDay.
The study was funded in part by Ethicon Endo-Surgery.
- Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric Surgery versus Intensive Medical Therapy for Diabetes - 5-Year Outcomes. N Engl J Med. 16 Feb 2017. doi: 10.1056/NEJMoa1600869