For the long-term control of type 2 diabetes in obese patients, metabolic or bariatric surgery may be more effective than standard medical treatments, as per a recent study.
The study by King's College London and the Universita Cattolica in Rome, Italy is the first to provide data on five-year outcomes of surgery from a randomized clinical trial specifically designed to compare this new approach against standard medical therapy for the treatment of type 2 diabetes.
Of the 60 patients enrolled on the trial, 53 completed the five-year follow-up which looked at the durability of diabetes remission, defined as achievement of a glycated haemaglobin A1c (HbA1c) concentration of 6.5 percent or less without the need for drugs for at least one year.
Additional outcome measures included relapse of hyperglycaemia (high blood sugar); use of anti-diabetic medication (glucose-lowering drugs and insulin) and cardiovascular medication (blood pressure and lipid-lowering drugs); changes in body weight, BMI and waist circumference; blood pressure; cholesterol; cardiovascular risk; quality of life, diabetes-related complications and long-term surgical complications.
Fewer diabetes-related complications were also observed in surgical patients in this study; however, the authors caution that the limitations of this trial, especially its relatively small sample size, do not allow definitive conclusions about the ability of surgery to reduce diabetes complications (e.g. heart attacks, strokes, kidney disease).
First author Geltrude Mingrone said that the surgery appears to dramatically reduce risk factors of cardiovascular disease. The study appears in Lancet