Bariatric surgery beats medical control for diabetes remission

(HealthDay)—Surgery is more effective than medical control for diabetes remission, with predictors including lower baseline glycemia and shorter diabetes duration, according to research published online Dec. 1 in Diabetes Care.

Simona Panunzi, Ph.D., from BioMatLab in Rome, and colleagues examined predictors of diabetes remission among 727 patients from the Swedish Obese Subjects study and two randomized controlled trials (415 surgical and 312 medical patients). Bariatric operations were classified as gastric only (GO) and gastric plus diversion (GD).

The researchers found that 64 and 15 percent of patients in the surgical and medical arms, respectively, experienced diabetes remission (P < 0.001). GO and GD yielded 60 and 76 percent remission, respectively. Lower baseline glycemia and shorter diabetes duration were the best predictors of diabetes remission. GD predicted higher likelihood of remission and greater weight loss when operation type was considered. Compared with non-responders, patients in remission (responders) lost more weight (25 versus 17 percent) and waist circumference (18 versus 13 percent) and experienced better insulin sensitivity.

"Surgery is more effective than medical treatment in achieving diabetes remission and tighter glycemic control," the authors write. "The results show the advantage of an early operation together with better controlled glycemia on diabetes remission independently of body mass index."

Several authors disclosed financial ties to the pharmaceutical and nutrition industries.