news release
Tuesday, February 27, 2024
NIH-supported studies have shown long-term benefits of surgery compared to medications and lifestyle changes.
Patients with type 2 diabetes who underwent bariatric surgery had better long-term blood sugar control than those who received medical management and lifestyle interventions, according to a new study supported by the National Institutes of Health. Participants who underwent bariatric surgery, also known as metabolic or weight loss surgery, were also more likely to stop needing diabetes medication and had higher rates of diabetes remission up to 12 years after surgery. The research results are Japan Automobile Manufacturers Association Funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the NIH.
“While there are many factors involved, not all of which are fully understood, bariatric surgery typically results in significant weight loss and affects metabolic hormones, which may increase the body’s response to insulin. “The response and ability to maintain healthy blood sugar levels is improved,” he said. Dr. Gene Lawrence, NIDDK Project Scientist. “These results show that people with overweight or obesity and type 2 diabetes can improve their long-term health and change the trajectory of their diabetes with surgery.”
The current study is a follow-up study that combines data from four independent single-center randomized trials conducted in clinical settings in the United States. The first trial, conducted from May 2007 to August 2013, tested adults with type 2 diabetes who were overweight or obese and tested them with intensive lifestyle changes and oral and injectable diabetes medications, including insulin. We evaluated the effectiveness of bariatric surgery compared to therapy. Some participants in this study were prescribed GLP-1 agonists as part of their medical management of diabetes, but these drugs were not specifically tested in the study. Researchers in four separate studies provide a larger, more geographically diverse dataset to evaluate the effectiveness, durability, and safety of bariatric surgery to treat type 2 diabetes We pooled the data for. Follow-up data was collected until July 2022.
A total of 262 participants from the four original studies enrolled in the current study. Of these, 166 were randomized to surgery, and he had one of three bariatric surgeries. The remaining 96 participants were randomly assigned to the medical/lifestyle management group. Medical/lifestyle interventions have previously been shown to be effective for weight loss. All participants were between the ages of 18 and 65 and were overweight or obese as measured by BMI. The primary outcome was measured over a 7-year period and continued for 12 years.
At 7 years, participants in the surgery group experienced an average weight loss of 20% compared to 8% for participants in the medical/lifestyle group. In the surgery group, glycemic control as measured by HbA1c improved significantly, with 54% of participants in the surgery group achieving an HbA1c below 7% compared to only 27% of participants in the medical/lifestyle group. was. Compared to participants in the medication/lifestyle group, more participants who underwent surgery achieved diabetes remission, with 98% of participants in the surgery group taking medication to treat their diabetes. 61%, but there was little change in the medication/lifestyle group.
Results and differences between groups remained significant at 12 years.
Additional exploratory analyzes in this study showed that bariatric surgery had a significant and beneficial effect on HbA1c and weight loss in participants with a BMI of 27 to 34 (within the overweight and underobese range). Shown. “These findings provide important information about the benefits of surgery in patients with type 2 diabetes who have not reached the traditional higher BMI threshold for bariatric surgery of 35,” said Chief of Minimally Invasive Bariatric Surgery and General Surgery. said Dr. Anita P. Kuhlas. from the University of Pittsburgh Medical Center and lead author of the study.
There were no differences in major adverse events between the two groups, but the number of events of fracture, anemia, iron deficiency, and gastrointestinal disorders were higher in the surgical group. Malnutrition can be a cause of bone fractures and anemia, highlighting the importance of continued monitoring of people undergoing bariatric surgery.
“Obesity and type 2 diabetes are complex conditions with many common risk factors and long-term complications,” said NIDDK Director Dr. Griffin P. Rogers. “This study shows how public investment in obesity and diabetes research can lead to real clinical advances and provide long-term health benefits for the millions of Americans who experience these conditions. It exemplifies what can be brought to the table.”
This research, known as Alliance for Randomized Clinical Trials in Medicine Versus Metabolic Surgery in Type 2 Diabetes (ARMMS-T2D) Supported by a cooperation agreement U01DK114156 From NIDDK.
NIDDK, part of the NIH, conducts and supports research in diabetes and other endocrine and metabolic diseases. Digestive diseases, nutrition, obesity. Diseases of the kidneys, urology, and hematology. These diseases span the entire spectrum of medicine, affect people of all ages and ethnic groups, and encompass some of the most common and seriously disabling conditions affecting Americans. For more information about NIDDK and its programs, see: https://www.niddk.nih.gov.
About the National Institutes of Health (NIH):The nation’s medical research agency, NIH, has 27 institutes and centers and is part of the U.S. Department of Health and Human Services. NIH is the primary federal agency that conducts and supports basic, clinical, and translational medical research, investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, please visit www.nih.gov.
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reference
Courcoulas AP, Patti ME, Hu B, et al. Long-term outcomes of medical management and bariatric surgery in type 2 diabetes. jam. 2024; Doi: 10.1001/jama.2024.0318.
