Surgery Better Than Medication Therapy for Long-Term Diabetes Control

Pharmacy Times, October 2015 Diabetes, Volume 81, Issue 10

Metabolic or bariatric surgery may be more effective than standard medical treatments at controlling type 2 diabetes in patients who are obese.

Metabolic or bariatric surgery may be more effective than standard medical treatments at controlling type 2 diabetes (T2D) in patients who are obese, according to study results published in the Lancet. The study, the first to provide data on longterm outcomes of surgery on patients with T2D, examined patients with diabetes aged 30 to 60 years with a body mass index of 35 kg/m² or more. Of 60 total patients, 40 received either gastric bypass surgery or biliopancreatic diversion surgery while the remaining 20 were given conventional medical treatment.

After a 5-year follow-up period, 19 of the 38 surgical patients who completed the study had achieved and maintained diabetes remission compared with none of the medically treated patients. The participants in the surgery group also experienced lower blood glucose levels, used considerably fewer diabetic and cardiovascular medications, and reported better quality-of-life (QOL) scores than those in the medicine group.

The researchers also determined that while biliopancreatic diversion yielded greater diabetes remission rates than gastric bypass at year 5 (67% vs 37%), gastric bypass was associated with fewer significant nutritional adverse effects and better QOL scores.

Although the study authors observed few diabetes-related complications in the patients who received surgery, they acknowledged that they cannot draw definitive conclusions about the ability of surgery to reduce diabetes complications due to the relatively small number of trial participants.