Bariatric Surgery vs Medical Treatment, Which Should Type 2 Diabetics Choose?

Surgery beats medicine over diabetes

Stick with conventional medical treatment or go under the knife? It’s not an easy choice to make when it comes to deciding how your Type 2 diabetes should be treated. Here’s what a new study recently revealed that could help you decide which is best for you.

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Mounting evidence is in agreement that bariatric weight loss patients who are very obese are benefitting from weight loss surgery. Not only are these patients losing a significant amount of weight and managing to keep the lost weight off, but are also benefiting with improved heart health and remission of their Type 2 diabetes.

But what about those who are not as obese with a Body Mass Index lower than 35? Is undergoing surgery really warranted and beneficial for results that go beyond the short term? According to a new study published in JAMA Surgery, it appears that even up to 5 years following bariatric surgery patients who are moderately overweight are having much better success with treating their Type 2 diabetes than similar patients who underwent conventional non-surgical medical treatment.

The published study was a retrospective look that made a comparison of the 5-year outcomes of patients with a BMI less than 35 and Type 2 diabetes, who were treated with either bariatric surgery (52 patients) or typical glycemic control measures (299 patients). The bariatric surgery consisted of 19 patients who opted for standard sleeve gastrectomy and 33 patients who chose to undergo a gastric bypass style procedure. Both groups were matched by age, BMI and duration of their diabetic condition. All patients were followed for a minimum of 5 years and evaluated for mean weight loss results and their diabetic status.

In the comparison, the researchers found that at the end of the 5th year:

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• The bariatric surgery group had a BMI improvement of 31.0 from the beginning of their treatment to a BMI of 24.5. And, the gastric bypass patients showed higher complete remission of type 2 diabetes than for sleeve gastrectomy (46.9% vs 16.7%, respectively), although both procedures worked equally well for overall weight loss. Regarding the effect of bariatric surgery on diabetes, 18 of the 33 gastric surgery participants (36.0%) had complete remission of their Type 2 diabetes, 14 (28.0%) had partial remission, 1 (1.9%) died, and 1 (1.9%) had end-stage renal disease.

• In the medical non-surgery group, the BMI’s were largely unimproved 5 years later and the number with an improved diabetic condition were significantly less than the surgical group with only 3 (1.2%) experiencing complete remission, 4 (1.6%) experiencing partial remission, 9 (3.0%) dying, and 2 (0.7%) succumbing to end-stage renal disease.

The researchers concluded that for mildly obese patients with Type 2 diabetes, glycemic control from metabolic surgery lasts at least 5 years; however, that additional longer-term studies need to be made to determine the survival benefit and lifelong adverse outcomes from using bariatric surgery for treating obesity and diabetes.

For more about options for individuals who are mildly obese, here is an informative article about a new weight loss procedure for patients not considered obese enough for bariatric surgery.

Reference: “Effect of Bariatric Surgery vs Medical Treatment on Type 2 Diabetes in Patients With Body Mass Index Lower Than 35” JAMA Surgery published online September 16, 2015; Chih-Cheng Hsu, MD et al.

Also Watch: 6 Easy Tips on Eating Less That May Help Your Weight Loss

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