Bypass surgery might be as effective as a weight-loss diet at reversing Type 2 diabetes.
In a recent study, a team from Newcastle University in England reported that an eight-week weight-loss diet and steady weight management can essentially cure type 2 diabetes and keep it from coming back in people who have had the condition for about 10 years. Although the findings from this study were promising, the results from an earlier study suggested that weight loss from gastric bypass surgery might be an even more effective way at treating diabetes.
In that study, researchers headed by David E. Cummings at the University of Washington in Seattle recruited 43 obese and diabetic adults between 25 and 64 years old. Twenty-three participants underwent gastric bypass surgery, which helps with weight loss by physically reducing stomach size and rearranging the intestines. The remaining 20 participants had to follow a strict lifestyle intervention plan that included exercising at least 45 minutes per day for five days a week and eating a diet that was planned out by a dietitian.
The researchers assessed several factors at the one-year follow up. These factors included insulin levels and sensitivity, fasting blood sugar levels, weight, waist circumference, cholesterol, aerobic fitness levels, medications and life quality. Eleven participants did not finish the study, which left the researchers with 15 in the surgery group and 17 in the intervention group.
After 12 months, 60 percent of the patients from the surgery group had blood sugar levels that were no longer in the range for diabetes. This rate was at just 6 percent in the intervention group. When the researchers compared insulin use in both groups, they found that less than 30 percent of the people who underwent surgery needed to use insulin. In the intervention group, 41 percent of the patients were still using insulin.
The study's findings suggest that for obese diabetics who are having a lot of issues losing weight, gastric surgery might be the most effective way at treating diabetes.
"The new thinking is might we begin to see surgery as a way to treat diabetes primarily," Cummings said.
"In those with severe or morbid obesity where multiple lifestyle intervention attempts have been unsuccessful, gastric bypass surgery is felt to be a good option by many experts," added Nathan D. Wong, director of the Heart Disease Prevention Program at the University of California, Irvine.
Wong noted that, of course, there are risks involved with surgery, which might not be ideal for every patient. Wong also pointed out that surgery and extremely strict diets would not be needed if people at risk of diabetes were encouraged to adopt healthier lifestyle habits.
"Patients with pre-diabetes should be more conscious of their lifestyle and what they can do to prevent diabetes as the Diabetes Prevention Program and other similar studies have clearly shown modest weight loss and exercise can go a long way towards preventing diabetes," Wong said. "Healthcare providers need to provide better support and resources to effect intensive lifestyle intervention."
The study was published in the journal Diabetologia.
