According to a new study, diabetic patients who had any type of bariatric surgery saw a greater chance of weight loss and less instances of microvascular or macrovascular complication then those treated with usual care treatment options. Swedish researchers found that in their researcher that nearly 15 years after having weight loss surgery over 30% of patients were no longer diabetic compared to just 7% of patients who used other conventional treatment options for their Type II Diabetes.
About the Study
The study looked at patients from September 1987 to January 2001. Nearly 260 of 2,037 control patients and 343 of 2,010 weight loss surgery patients had Type II Diabetes at the time of their surgery. The weight loss surgery patients had adjustable, non-adjustable or vertical banded gastroplasty or Roux-en-y gastric bypass surgeries. The mean age of the patients was 50 with a median BMI of 41. 60% of those studied were women. All of those studied had their diabetes condition for an average of 3 years.
The study looked mostly at relapse, incidence of diabetes-related complications and diabetes remission. Remission was characterized as having a fasting blood glucose below 110mg/dL and not having to take diabetic medication. The limitations of the studies were lack of randomization as well as a significant loss of participants as the 15 year span continued.
The patients studied in the control group received normal pharmacological treatment and lifestyle changes for their obesity and diabetes condition at a primary health facility. Both groups had identical follow-up visits throughout the duration of the study.
The patients who underwent bariatric surgeries had a higher remission rate (30% versus 7% at 15 years) as well as greater weight loss about 50 pounds versus 10 pounds at the 10-year mark. One important note in the study is that after two years post-surgery, 72% of all patients were in remission, which shows that a significant number of those studied did relapse back to their Type II Diabetes condition.
The bariatric surgery group was also associated more with a decreased risk for macrovascular (31.7 versus 44.2 per 1,000 patients) and microvascular complications (20.6 versus 41.8 per 1,000 patients). The study believed that bariatric surgery was associated with a 20-year reduced incidence of myocardial infarctions. The study’s researchers also believe that tight glycemic control along with lifestyle changes and drug treatments help to reduce the incidence of microvascular disease in non-surgery patients. Lifestyle changes have been found to not significantly reduce diabetes-associated disease.
Dr. Anne Cappola of the Perelman School of Medicine at the University of Pennsylvania and an associate editor for JAMA believes that the study shows realistic expectations for bariatric surgery and Type II Diabetes patients.
The study was published in the Journal of American Medical Association entitled, “Association of Bariatric Surgery with Long-Term Remission of Type 2 Diabetes and With Microvascular and Macrovascular Complications.”