In a group of diabetes mellitus type 2 (DM2) patients who underwent bariatric surgery, up to forty percent experienced disease remission, whereas the patients with only lifestyle interventions remained dependent on medication. Those are the results of a cohort study with 52 DM2 patients from the US, published in JAMA Surgery.
The research group from Pennsylvania is not the first to propose bariatric surgery as a solution for DM2. Especially in morbidly obese patients who are unresponsive to drugs, this procedure has been performed more frequently. However, every surgery has its risks and knowledge on long-term effects in DM2 patients is limited.
To this end, the scientists chose to perform a broad cohort study with three treatment options and a three-year follow-up with low-level lifestyle interventions. They compared the long-term effects of gastric bypass surgery (RYGB), laparoscopic adjustable gastric banding (LAGB) and an intensive lifestyle weight loss intervention on disease remission, medication use and weight in DM2 patients. Furthermore, non-morbidly obese (BMI 30 to 35) type 2 diabetics were included to investigate the effects of bariatric surgery in this often neglected group.
After three years, 45 percent of the RYGB group (n=18), 29 percent of the LAGB group (n=20) and no patients of the lifestyle intervention group (n=14) showed disease remission during at least two consecutive years and no longer needed medication. These results did not differ between the obesity groups.
Overall, the researchers conclude that bariatric surgery is a viable treatment option for DM2 patients, but only in the case of lacking drug response. The risk of complications due to surgery remains a limiting factor for general implication.
Sources: JAMA Surgery, MedPage Today
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