In obese patients, bariatric surgery can aid in achieving sustainable remission and improvement of type 2 diabetes mellitus (T2DM), according to a study published in the October issue of the Annals of Surgery.
Stacy A. Brethauer, M.D., from the Cleveland Clinic, and colleagues assessed clinical outcomes in patients with T2DM who underwent bariatric surgery between 2004 and 2007 and were followed for a median of six years. Glycated hemoglobin (A1C) <6 percent and fasting blood glucose (FBG) <100 mg/dL while off diabetes medications defined complete remission.
The researchers found that a mean excess weight loss (EWL) of 55 percent was associated with significant mean reductions in A1C and FBG. Compared to baseline, over one-third of patients (34 percent) had improved A1C (>1 percent decrease without remission) and 16 percent remained unchanged, while long-term complete and partial remission rates were 24 and 26 percent, respectively. Remission was significantly predicted by shorter duration of T2DM and higher long-term EWL. After initial remission, recurrence of T2DM occurred in 19 percent and was significantly associated with longer duration of T2DM, less EWL, and weight regain.
“Surgical intervention within five years of diagnosis is associated with a high rate of long-term remission,” the authors write.