Bariatric surgery might be more impactful than lifestyle for type 2 diabetes remission: Study

According to research, through bariatric surgery, type 2 diabetes can be cured faster and with longer lasting effects than with medications and lifestyle modifications.

A new study from the Pennington Biomedical Research Center, published in the journal Diabetes Care, evaluated 316 patients with type 2 diabetes to determine the effectiveness and long-term results of metabolic surgery. This is the largest study to date to evaluate metabolic surgery, also known as bariatric surgery, as a treatment for type 2 diabetes.

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According to the Centers for Disease Control and Prevention, more than 34.2 million Americans, or 10.5 percent of the population, have type 2 diabetes. Obesity is a major contributing factor in the development of diabetes . About 90 percent of people with type 2 diabetes are overweight or obese. These intertwined chronic health problems cause an enormous health burden on both an individual and societal level.

“Treatment guidelines from the American Medical Association, the American Diabetes Association, and many other leading medical organizations indicate that metabolic surgery is an effective treatment for type 2 diabetes,” said Pennington Biomedical CEO John Kirwan, PhD. , who led the study. “Despite growing consensus, many health insurers do not provide coverage for metabolic surgery because we haven’t had a large enough randomized controlled trial that looked at how long the results of surgery last in relation to medications and lifestyle changes.”

“Even when patients receive education on nutrition, exercise, self-management, and the newest diabetes medications on the market, only 2.6 percent of patients were able to achieve diabetes remission during the study,” notes Dr. Kirwan. “When we looked at patients who underwent metabolic surgery, even three years later, 37.5 percent had achieved a durable remission of their diabetes,” he added.

The study notes that fewer than 1 percent of people eligible for bariatric surgery receive the treatment, likely due to concerns by both patients and their providers about long-term safety and lasting results.

The study also found that metabolic surgery was superior to medication and lifestyle changes in lowering HbA1c, fasting glucose, body weight, and other cardiovascular risk factors with substantially less medication.

“We hope that physicians will be more confident in recommending bariatric surgery to their patients, and that health insurers will see the health benefits and ultimately the savings that can be achieved by covering metabolic surgery,” said Dr. Dr Kirwan.

This work was supported by an investigator-initiated grant from Ethicon Endo-Surgery and Medtronic, and by in-kind support from LifeScan and Novo Nordisk. This work was also supported in part by award number U01DK114156 from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health.

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