Bariatric Surgery vs. Drug Tx for Metabolic Outcomes in T2DM

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Bariatric Surgery vs. Drug Tx
Bariatric Surgery vs. Drug Tx

(HealthDay News) — Regardless of weight loss, patients with type 2 diabetes who undergo bariatric surgery have better metabolic outcomes than patients treated with drug therapy, according to a study published in the September 5 issue of The Lancet.

Francesco Rubino, MD, of King's College London, and colleagues tracked five-year outcomes for 53 obese patients with type 2 diabetes. The patients were randomly selected to undergo gastric bypass or biliopancreatic diversion, or to continue with drug therapy.

The researchers found that the surgical patients lost more weight than medically treated patients, but change in weight was not predictive of diabetes remission or relapse after surgery. Half of the 38 surgery patients maintained diabetes remission, compared with none of the 15 patients in the drug therapy group. Relapse of hyperglycemia was recorded in 53% of patients who achieved two-year remission in the gastric bypass group and 37% of the patients who achieved two-year remission in the biliopancreatic diversion group. Both procedures were associated with significantly lower plasma lipids, cardiovascular risk, and medication use, the researchers noted. None of the patients in the surgery group died or had late complications.

Regardless of whether or not their diabetes went into full remission, patients who underwent surgery still tended to have better control of blood glucose levels as measured by HbA1c than those only treated with drugs. "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," Rubino said in a news release from the college, where he is chair of bariatric and metabolic surgery.

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