A new study published in the journal Diabetes Care revealed that bariatric surgery is more effective in inducing diabetes remission than medical control. The study is entitled “Determinants of Diabetes Remission and Glycemic Control After Bariatric Surgery.”
Bariatric surgery is a weight loss surgery where the size of the stomach is reduced through a gastric band or through removal of part of the stomach. This surgery is highly effective in inducing long-term sustained weight loss and has been shown to contribute to health improvements and a decreased incidence of medical conditions like diabetes, heart attack, stroke and cancer. In patients with diabetes, bariatric surgery is only performed if the individual has a poor glycemia control and a body mass index equal or higher than 35 kg/m2.
In order to determine the impact of bariatric surgery in glycemic control and predictors of diabetes remission, researchers analyzed 727 patients from the Swedish Obese Subjects study and two clinical trials. In total, 415 patients underwent surgery, while the other 312 underwent medical control. Within the bariatric surgery group, patients were divided according to the procedure — gastric only (GO) or gastric plus diversion (GD).
Researchers found that 64% of the patients in the surgical group and 15% in the medical control group achieved diabetes remission. Within the surgical group, 60% of the GO and 76% of the GD experienced remission. The team found that the best predictors of diabetes remission were shorter diabetes duration and a lower baseline glycemia, while waist circumference and baseline HbA1C levels (measure of the average blood sugar) were predictors of an improved glycemic control.
In terms of type of surgery, GD was found to predict a higher likelihood of diabetes remission and greater weight loss. Furthermore, researchers reported that patients in remission (responders to treatment) lost more weight in comparison to non-responders (25 versus 17%, respectively), and also had a greater reduction in waist circumference (18 versus 13%), and exhibited better insulin sensitivity.
“Surgery is more effective than medical treatment in achieving diabetes remission and tighter glycemic control,” concluded the research team according to a news release. “The results show the advantage of an early operation together with better controlled glycemia on diabetes remission independently of body mass index.”