Metabolic Surgery Beats Medical, Lifestyle Interventions for T2D Remission

Additional benefits from surgery seen for diabetes-related comorbidities and weight loss
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MONDAY, Sept. 19, 2022 (HealthDay News) -- Metabolic or bariatric surgery is more effective and durable than medical and lifestyle interventions for achieving remission of type 2 diabetes, according to a study published in the July issue of Diabetes Care.

John P. Kirwan, Ph.D., from the Cleveland Clinic, and colleagues assessed the durability and three-year effectiveness of metabolic surgery versus medical and lifestyle management in patients with type 2 diabetes. The analysis included 316 patients (body mass index, 27 to 45 kg/m²) with type 2 diabetes randomly assigned to either surgery (195 patients) or medical and lifestyle therapy (121 patients).

The researchers found that diabetes remission was achieved in more participants following surgery than medical and lifestyle intervention (37.5 versus 2.6 percent). After surgery, there were also greater reductions seen in hemoglobin A1c (−1.9 versus −0.1), fasting plasma glucose (−52 versus −12 mg/dL), and body mass index (−8.0 versus −1.8 kg/m²). Finally, the percentages of patients using medications to control diabetes, hypertension, and dyslipidemia were all lower after surgery.

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

The study was funded in part by Ethicon Endo-Surgery; several authors disclosed financial ties to the pharmaceutical and biotechnology industries.

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