Bariatric surgery more effective than lifestyle changes for type 2 diabetes remission

Bariatric surgery more effective than lifestyle changes for type 2 diabetes remission
CONSORT diagram. A total of 355 patients were previously randomly assigned into the parent trials, 39 of whom did not undergo intervention and were excluded from analysis. A total of 316 (N = 195 surgical and N = 121 medical/lifestyle) patients were assessed for eligibility and participation in the ARMMS-T2D trial. A total of 60 (N = 24 surgical and N = 36 medical/lifestyle) patients were excluded from analysis based upon missing HbA1c values at 3 years. A total of 256 (N = 171 surgical and N = 85 medical/lifestyle) patients were included in analysis of primary and secondary outcomes. Credit: Diabetes Care (2022). DOI: 10.2337/dc21-2441

Remission of type 2 diabetes is achieved more effectively and has longer-lasting results with bariatric surgery than through medications and lifestyle changes.

A new study from Pennington Biomedical Research Center, published in the journal Diabetes Care, assessed 316 patients with type 2 diabetes to determine the effectiveness and long-term results of metabolic surgery. This is the largest study to date to evaluate metabolic surgery, also known as bariatric surgery, as a treatment for type 2 diabetes.

According to the Centers for Disease Control and Prevention, more than 34.2 million Americans, or 10.5 percent of the population, have type 2 diabetes. Obesity is a significant contributory factor in the development of diabetes. Approximately 90 percent of people with type 2 diabetes are overweight or have obesity. These intertwined cause an enormous health burden on both the individual and societal level.

"Treatment guidelines from the American Medical Association, American Diabetes Association, and many other leading medical organizations, are that metabolic surgery is an effective treatment for type 2 diabetes," said Pennington Biomedical Executive Director John Kirwan, Ph.D., who led the study. "Despite growing consensus, many health insurers do not provide coverage for metabolic surgery because we haven't had a sufficiently large, randomized controlled trial that considered how long the results of surgery last relative to medications and ."

"Even when patients are provided with education in nutrition, exercise, self-monitoring and the newest diabetes medications on the market, only 2.6 percent of patients were able to achieve diabetes remission during the study," Dr. Kirwan notes. "When we looked at patients who underwent metabolic surgery, even three years later, 37.5 percent had achieved lasting remission of their ," he added.

The study notes that less than one percent of individuals eligible for bariatric surgery receive the treatment, likely due to both patients' and their providers' concerns about long-term safety and lasting results.

The study also found that metabolic surgery was superior to medication and lifestyle changes in lowering HbA1c, fasting glucose, , and other cardiovascular risk factors with substantially less medications.

"It is our hope that physicians will have greater confidence in recommending to their patients, and that health insurers will see the health benefits and ultimately, cost-savings that can be achieved by covering ," Dr. Kirwan said.

More information: John P. Kirwan et al, Diabetes Remission in the Alliance of Randomized Trials of Medicine Versus Metabolic Surgery in Type 2 Diabetes (ARMMS-T2D), Diabetes Care (2022). DOI: 10.2337/dc21-2441

Journal information: Diabetes Care
Provided by Pennington Biomedical Research Center
Citation: Bariatric surgery more effective than lifestyle changes for type 2 diabetes remission (2022, September 1) retrieved 28 March 2024 from https://medicalxpress.com/news/2022-09-bariatric-surgery-effective-lifestyle-diabetes.html
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