MONDAY, March 31, 2014 (HealthDay News) -- Weight-loss surgery
might do more than help people shed pounds. For some who have the
surgery, it may also put type 2 diabetes into remission for several
years, a new study suggests.
The success rate in controlling diabetes depended on the type of
weight-loss surgery, the researchers said.
Patients who had the more involved gastric-bypass surgery were
more likely to achieve control of their type 2 diabetes without the
use of medications, compared to those who had a procedure known as
sleeve gastrectomy, according to the new research.
"This study is a three-year follow-up. Initially, we showed that people lost a lot of weight after surgery, and for some people, that caused their type 2 diabetes to come to an end," said study co-author Dr. Sangeeta Kashyap, an endocrinologist at the Cleveland Clinic's Endocrinology & Metabolism Institute. "But no one knew how lasting that would be."
"One-third [of patients] in the gastric bypass group had remission of diabetes -- meaning they had normal blood sugar control -- and a quarter of the people in the sleeve gastrectomy group had remission of type 2 diabetes," Kashyap said. "These effects are real, and they're persistent for at least three years. Essentially, these patients have had a vacation from diabetes for three years."
Even when people weren't able to achieve a full remission from
type 2 diabetes, weight-loss surgeries still helped many
participants take less medication to control their blood sugar,
according to the study.
Kashyap also said quality of life was improved for people who
had the weight-loss surgery compared to those who received standard
type 2 diabetes management. Quality-of-life measures included
bodily pain, physical functioning, energy levels and emotional
"People who have weight-loss surgery generally feel better, happier and healthier," Kashyap said.
The study was funded by Johnson & Johnson subsidiary
Ethicon, which makes surgical devices.
Results of the study will be presented Monday at the American
College of Cardiology annual meeting in Washington, D.C., and
published in the March 31 issue of the
New England Journal of Medicine.
Type 2 diabetes causes the body to use the hormone insulin
inefficiently. Insulin helps get sugar from the blood into the
body's cells to be used as fuel. When cells become insulin
resistant, that fuel can't make it into the cells and instead
builds up in the blood. High levels of sugar in the blood over long
periods of time can cause serious complications, such as kidney and
heart disease, according to the U.S. National Institute of Diabetes
and Digestive and Kidney Diseases (NIDDK).
Although the exact cause of type 2 diabetes remains unknown, one
of the biggest risk factors for developing the disease is
The current study included 150 people with type 2 diabetes.
Their average age was 49, and two-thirds were female. At the start
of the study, the patients' average body-mass index (BMI) -- a
rough estimate of a person's body fat -- was nearly 37. Below 25 is
considered normal weight and over 30 is considered obese, according
to the U.S. Centers for Disease Control and Prevention.
One-third of the study volunteers were randomly selected to
receive standard medical management of their type 2 diabetes, while
another third was given gastric-bypass surgery and medical
management. The final third received sleeve gastrectomy plus
medical management of their diabetes.
Gastric-bypass surgery routes food directly to the small
intestine, which means it bypasses the stomach, duodenum and large
intestines, according to the NIDDK. Sleeve gastrectomy reduces the
size of the stomach.
Kashyap said the biggest benefits of the surgeries likely stem
from the amount of weight lost. "When you're taking drugs to manage
diabetes, it's hard to lose significant amounts of weight," she
said. "A lot of diabetes medications make weight loss hard."
Weight-loss surgery costs about $25,000 to $30,000, Kashyap
said, and requires about two to four weeks time off of work.
Insurance companies generally pay for the procedure only for people
who have a BMI over 35, she said.
Because experts at the Cleveland Clinic believe weight-loss
surgery can be beneficial for people with lower BMIs who also have
other health problems, such as type 2 diabetes, their insurance
program pays for the procedure in people with BMIs as low as 30,
Although weight-loss surgery can help some people, however, it
might create new problems, according to an expert not involved in
"This study reassures that these procedures work, and may be worth trying in some patients," said Dr. Joel Zonszein, director of the clinical diabetes center at Montefiore Medical Center, in New York City. "But they're not ... a cure. You're changing one disease (type 2 diabetes) for another (malabsorption)."
Malabsorption -- nutrients being poorly absorbed in the body --
can be a later effect of weight-loss surgery, according to the
Still, Zonszein said, in people who don't respond well to type 2
diabetes medications or who don't tolerate them well, "they may do
much better with surgery. We really have to look at each patient
Learn more about the types of weight-loss surgery from the
U.S. National Institute of Diabetes and Digestive ...
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