For Diabetes, Surgery May Have Better Outcomes

Bariatric surgery for type 2 diabetes may have better outcomes than standard treatments

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) For the growing number of type 2 diabetes patients in the US, standard medical treatments might not be the only effective option.

A new study found that bariatric (weight loss) surgery may be more effective in treating obese type 2 diabetes patients than standard medical treatments, such as medication and insulin therapy.

"The ability of surgery to greatly reduce the need for insulin and other drugs suggests that surgical therapy is a cost-effective approach to treating type-2 diabetes," said lead study author Dr. Francesco Rubino, chair of bariatric and metabolic surgery at King's College London, in a press release.

The idea that weight loss surgery can help with type 2 diabetes isn't new — several past studies have reached that conclusion. This study, however, looked at longer-term outcomes for type 2 diabetes patients who underwent surgery.

More specifically, Dr. Rubino and team looked at 60 obese type 2 diabetes patients in Italy who had either surgery or standard treatment. These researchers followed these patients, whose ages ranged from 30 to 60, for five years.

Patients in the surgery group received either gastric bypass or biliopancreatic diversion. In gastric bypass, a surgeon reduces the size of the stomach and reroutes the small intestine. In biliopancreatic diversion, a surgeon reroutes the intestines to reduce the body's ability to absorb nutrients from food.

Type 2 diabetes is a chronic condition in which the body does not produce enough insulin, the hormone that regulates blood sugar. This results in high blood sugar. Obesity is a risk factor for diabetes, which may be why weight loss surgery can help with the disease.

Untreated diabetes has been tied to heart and kidney disease, among other health problems.

What Dr. Rubino and team were looking for is called diabetes remission. This means that patients had normal blood levels of a protein — called glycated hemoglobin — for one year without the use of medication. In type 2 diabetes patients, blood levels of this protein are usually high.

Five years after surgery, 19 of the 38 patients who had surgery were still in remission, Dr. Rubino and team found. None of the patients in the standard treatment group were in remission after five years.

Even surgery patients who were not in remission at five years had lower average blood sugar levels than medically treated patients, Dr. Rubino and team noted.

And despite the more invasive nature of surgery, Dr. Rubino and team reported no deaths or long-term complications.

There were some differences among the surgery patients. Among the patients who underwent biliopancreatic diversion, 67 percent were in diabetes remission after five years. For those who underwent gastric bypass, that figure was 37 percent. But fewer gastric bypass patients had short-term surgery side effects or low quality of life, Dr. Rubino and team found.

This study was published Sept. 3 in The Lancet.

The Catholic University of Rome funded this research. Dr. Rubino and team disclosed no conflicts of interest.

Review Date: 
September 3, 2015
Last Updated:
September 9, 2015