Bariatric surgery could be effective in treating type 2 diabetes in obese patients. The surgery has allowed patients to be free of insulin and other diabetic medications only three years after the procedure.
A recent study also showed that bariatric surgery patients had an improved quality of life and a reduced need for cardiovascular medications to treat blood pressure and cholesterol, a Cleveland Clinic news release reported.
"We see patients whose lives are ravaged by diabetes. At the three-year mark, this study shows that bariatric surgery is more effective with persistent benefits noted up to [three] years for treating type 2 diabetes in moderate and severely obese patients when compared to medical therapy," Sangeeta Kashyap, M.D., one of the lead investigators and an endocrinologist at Cleveland Clinic's Endocrinology & Metabolism Institute, said in the news release. "More than 90 percent of the patients who underwent bariatric surgery were able to lose 25 percent of their body weight and control their diabetes without the use of insulin and multiple diabetes drugs."
The researchers looked at 150 patients who suffered from poorly-controlled diabetes. Fifty of the patients received intensive medical therapy alone, 50 received t Roux-en-Y gastric bypass surgery along with medical therapy, and 50 underwent both sleeve gastrectomy and intensive therapy.
The patients in the gastric bypass group proved to be most successful (37.5 percent) in achieving blood sugar control without the use of medications; 24.5 percent of the patients in the sleeve gastrectomy group and five percent in the medical group achieved this kind of blood sugar control.
"The three-year data confirm that bariatric surgery maintains its superiority over medical therapy for the treatment of type 2 diabetes in severely obese patients," lead investigator Philip Schauer, M.D., Director of the Cleveland Clinic Bariatric and Metabolic Institute, said in the news release. "Moreover, data show that bariatric surgery is as effective in treating type 2 diabetes in patients with mild obesity. That's why Cleveland Clinic health insurance plan now covers bariatric surgery for its members with mild obesity and uncontrolled diabetes."
The gastric bypass group had lower levels of albumin in their urine, which indicates kidney damage. This group showed an improvement in "five of eight mental and physical domains" on a questionnaire; there was improvement in only two of these domains in the sleeve gastrectomy group and none at all in the medical group.
"We looked at quality of life, because ultimately it is all about helping our patients live a healthier, happier life," doctor Schauer said. "When compared to sleeve gastrectomy and medical therapy, gastric bypass patients achieved greater weight loss, were on fewer medications, had a higher success rate in controlling their diabetes, and an improved quality of life."
