For Type 2 Diabetes, Surgery May Boost Hope

Weight loss surgery may be more effective for type 2 diabetes than lifestyle changes alone

(RxWiki News) Doctors usually advise patients with type 2 diabetes to eat better and exercise more, but these lifestyle changes may not be enough in some cases.

A new study found that weight loss surgery may be more effective in treating type 2 diabetes than lifestyle changes alone.

"Among obese participants with type 2 diabetes, bariatric surgery with two years of [following] low-level lifestyle intervention resulted in more disease remission than did lifestyle intervention alone," wrote lead study author Anita P. Courcoulas, MD, a bariatric and general surgeon at the University of Pittsburgh School of Medicine (UPMC), and colleagues.

Weight loss (bariatric) surgery includes a variety of procedures performed on obese patients. Weight loss is achieved by reducing the size of the stomach with a gastric band, through the removal of a portion of the stomach or by rerouting the small intestine to a small stomach pouch.

Obese patients are often diagnosed with type 2 diabetes, and losing weight may help lessen the symptoms of this condition.

Patients with diabetes either have a total lack of insulin (type 1 diabetes) or they have too little insulin or cannot use insulin effectively (type 2). Insulin is a hormone produced in the pancreas that allows blood sugar (glucose) to enter the body's cells, where it is used for energy.

Dr. Courcoulas and team compared a group of type 2 diabetes patients who underwent weight loss surgery to a group of type 2 diabetes patients who instead underwent an intensive lifestyle weight loss program.

All patients received guidance for healthy lifestyle changes during the last two years of this study.

After three years, about one-third of the weight loss surgery group was in partial or complete remission (some or all of their symptoms had disappeared). However, none of the lifestyle intervention patients were in remission.

Dr. Courcoulas and team concluded that weight loss surgery is “superior to lifestyle intervention alone for the remission of type 2 diabetes in obese individuals, including those with a BMI between 30 and 35.”

Body mass index (BMI) is a measure of body fat based on height and weight. A BMI of 18.5 to 24.9 is considered normal, a BMI of 25 to 29.9 is considered overweight, and a BMI of 30 or more is considered obese.

In an editorial about this study, Michael Gagner, MD, of Florida International University, wrote, "We should consider the use of bariatric surgery in all severely obese patients with type 2 diabetes and start a mass treatment, similar to what was done with [heart bypasses] more than 50 years ago."

This study was published July 1 in the journal JAMA Surgery.

The National Institutes of Health and Magee-Women’s Hospital of UPMC funded this research. Multiple authors disclosed financial ties to weight loss companies and medical device companies.

Review Date: 
June 30, 2015