Surgery Tops Drugs for Obesity and Diabetes

Obese type 2 diabetes patients do better after weight loss surgery compared to drug treatment

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Diet and exercise are the best ways to prevent and treat diabetes. However, that approach does not work for everyone. Once again, researchers have found that surgery is a powerful treatment for obese diabetes patients.

Sleeve gastrectomy, a type of weight-loss surgery, is a more effective way to control type 2 diabetes in morbidly obese patients, compared to usual drug treatment.

"Ask your doctor about weight-loss surgery."

Recently, study after study has revealed that weight-loss surgery may be a better diabetes treatment than conventional drug therapy for obese diabetes patients.

Now, new research by Nicola Basso, M.D., of the University of Rome, and colleagues has confirmed the findings of these other recent studies.

In a study of 60 morbidly obese patients with type 2 diabetes, Dr. Basso and a team of researchers found that sleeve gastrectomy led to better improvement of diabetes compared to normal drug treatment, according to a variety of measures.

These measures included body mass index (a measure of body fat using height and weight), fasting plasma glucose level (blood sugar levels without eating), and HbA1c levels (a measure of blood sugar over three months).

While patients receiving normal drug therapy had modest improvements, the vast majority of surgery patients were able to overcome diabetes.

Patients who underwent surgery lowered their BMI more than those on normal drug treatment.

Among surgery patients, fasting plasma glucose levels improved from 166.6 mg/dL to 96.2 mg/dL. HbA1c levels decreased from 7.9 percent to 6.0 percent.

Among patients on normal drug treatment, fasting plasma glucose improved from 183.7 mg/dL to 150 mg/dL, and HbA1c levels went from 8.1 percent to 7.1 percent.

Most importantly, 80 percent of the surgery patients were diabetes-free by the end of the study. In contrast, every patient who received normal drug therapy still had diabetes by the end.

With regards to other problems associated with obesity, the rate of sleep apnea (when breathing repeatedly stops and starts during sleep) among surgery patients dropped from 50 percent to 10 percent.

According to the American Diabetes Association, a normal HbA1c level is less than 5.7 percent. Pre-diabetes sets in at 5.7 percent, and diabetes starts at 6.5 percent or above. A normal fasting plasma glucose level is less than 100 mg/dL, while 126 mg/dL or more is in the range of diabetes.

The authors conclude that sleeve gastrectomy is better than conventional medical treatment for morbidly obese type 2 diabetes patients.

This is one more study to add to the body of evidence showing that surgery eliminates diabetes more effectively than drug treatment.

The results are published in the Archives of Surgery.

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Review Date: 
April 17, 2012
Last Updated:
August 27, 2012