Home Type 2 Study finds weight loss surgery has long-term benefits for diabetics

Study finds weight loss surgery has long-term benefits for diabetics

by Mira Cheng, CNN
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Bariatric surgery, also known as weight loss surgery, improves blood sugar control and reduces long-term drug use in people with type 2 diabetes compared to non-surgical management with drugs such as insulin and metformin, a new study finds. . Related Video Above: Am I a Candidate for Weight Loss Surgery? The study, published Tuesday in the journal JAMA, found that patients who have no choice but to undergo weight loss surgery or receive nonsurgical medical management, such as medications or They compared blood sugar levels and medication regimens in 262 randomly assigned patients. Researchers from the University of Pittsburgh and other institutions found that participants who underwent weight-loss surgery had significantly lower blood sugar levels and took fewer diabetes medications than those who did not undergo surgery. , I have written. They were also more likely to achieve diabetes remission (defined as maintaining non-diabetic blood sugar levels for at least 3 months without medication). The study “provides the most robust evidence to date of the long-term effectiveness of bariatric surgery for improving the control of type 2 diabetes,” said Dr. McConlogue, professor of psychology at the Perelman School of Medicine at the University of Pennsylvania and professor of psychology at the Perelman School of Medicine at the University of Pennsylvania. said Dr. Thomas A. Wadden, former director of the Disability Center, in an editorial published in October 2016. According to the National Institute of Diabetes and Digestive and Kidney Diseases, weight loss surgery is a procedure that alters the digestive tract (usually reduces the size of the stomach) in order to lose weight. Changes in food intake and neurohormones also lower blood sugar levels, thereby treating type 2 diabetes, Dr. Marilyn Tan, chief of the Endocrinology Clinic at Stanford Health Care, who was not involved in the study, emailed CNN. I wrote it in “This is a more invasive option than traditional diabetes drugs, and it’s a huge burden and an investment in your long-term health,” Tan said. Currently, most health care providers do not recommend weight loss surgery for type 2 diabetes. The study found that less than 1% of people with a body mass index (BMI) of 35 or higher end up undergoing surgical treatment. However, Professor Wadden said in an email to CNN that the new findings support expanding the use of bariatric surgery. “We hope that these results will encourage more insurance companies and payers to cover bariatric surgery for patients with type 2 diabetes with a BMI of 30 to 34.9,” he said. “This is a very effective long-term therapy for these people.” Nonsurgical medical management of type 2 diabetes includes lifestyle changes such as reducing carbohydrate intake and increasing physical activity, metformin and Some include the use of drugs such as insulin, Tan said. The goal is to lower his hemoglobin A1c, a measure of average blood sugar levels over a three-month period, to below 7%. “I have had patients administering hundreds of units of insulin a day and, despite their best efforts, unable to get their insulin in.” Keeping A1cs below 10% Let’s do it,” Mr Tan said. “Then, after bariatric surgery, people were able to keep their A1c levels below the diabetic range without medication. The researchers also noted that losing weight helped people be more active.” Further research is needed to compare clinical outcomes and cost-effectiveness of body weight. The editorial discusses the effectiveness of weight loss surgery and new generation antidiabetic drugs such as Ozempic and Munjaro. Weight loss after surgery is key to improving diabetes outcomes and heart health, Tan said. Losing weight improves your body’s response to insulin, reduces inflammation, and lowers blood pressure and cholesterol. It can also improve arthritis, allowing you to exercise more, she added. The study’s results also support the heart health benefits of weight loss surgery. People in the surgery group had significantly higher HDL, or “good” cholesterol, and lower triglycerides, a type of fat that can increase the risk of heart disease and stroke. Despite the benefits, many people are hesitant to undergo weight loss surgery because it is invasive, said Tan, who said it comes with some risks. The study found that gastrointestinal complications such as anemia (lack of healthy red blood cells), bone fractures, abdominal pain, nausea, and vomiting were more common in people who had weight loss surgery. Complications are caused by nutritional deficiencies that can occur if the gastrointestinal tract is surgically altered. “People who have had surgery should change their diet and take vitamins regularly to avoid these problems,” Tan said. “Even people who have had surgery may regain the weight they lost. Yes,” she added. “Despite having surgery, weight can be regained if the patient regains it.” The study found that 51% of participants who underwent surgical treatment had complete remission of type 2 diabetes after one year. achieved, but found that only 18% remained in remission after seven years. According to the editorial, the decreased remission after surgery that has been observed in previous studies is likely due to a combination of weight regain and a decrease in insulin-producing cells over time. Even short-term remission of diabetes has benefits in the following ways: The editorial says it is effective in reducing diabetes-related complications such as eye, kidney, and peripheral vascular disease. Although bariatric surgery has a higher initial cost than medical management (approximately $33,000 before insurance), it is considered more cost-effective. According to the editorial, five years after the surgery.

Bariatric surgery, also known as weight-loss surgery, improves blood sugar control in people with type 2 diabetes and reduces long-term drug use compared to non-surgical management with drugs such as insulin and metformin. be new research found.

Related video above: Am I a candidate for weight loss surgery?

of studyThe paper, published Tuesday in the journal JAMA, studied 262 people who were randomly assigned to undergo weight loss surgery or nonsurgical medical management, such as medications and lifestyle changes, for type 2 diabetes. Blood sugar levels and medication regimens were compared between 7:00 and 12:00. Year.

Participants who underwent weight-loss surgery had significantly lower blood sugar levels and took fewer diabetes medications than those who did not undergo surgery, researchers from the University of Pittsburgh and elsewhere wrote. They were also more likely to achieve diabetes remission (defined as maintaining non-diabetic blood sugar levels for at least three months without medication).

The study “provides the most robust evidence to date of the long-term effectiveness of bariatric surgery to improve control of type 2 diabetes,” said Professor of Psychology and former director of the Center for Weight and Eating Disorders. As one Dr. Thomas A. Wadden said: from the Perelman School of Medicine at the University of Pennsylvania, wrote in an editorial published with his study:

According to , weight loss surgery is a surgery that alters the digestive tract (usually reduces the size of the stomach) in order to lose weight. National Institute of Diabetes and Digestive and Kidney Diseases.

As a result, food intake is reduced, and neurohormonal changes also lower blood sugar levels, thereby treating type 2 diabetes, said Marilyn Tan, Ph.D., chief of the Endocrinology Clinic at Stanford Health Care, in the study. told CNN in an email that he was not involved.

“This is a more invasive option than traditional diabetes drugs and requires a lot of effort, but it’s also an investment in your long-term health,” Tan said.

Currently, most health care providers do not recommend weight loss surgery for type 2 diabetes unless the person has a body mass index (BMI) of 35 or higher, and less than 1% of people ultimately receive surgical treatment. study.

However, Wadden said in an email to CNN that the new findings support expanding the use of bariatric surgery for people with a body mass index below 35 who have difficulty controlling blood sugar with medical management alone.

“We hope that these results will encourage more insurance companies and payers to cover bariatric surgery for patients with type 2 diabetes with a BMI of 30 to 34.9,” he said. “For these people, this is a very effective, long-term treatment.”

Tan said non-surgical medical management of type 2 diabetes includes lifestyle changes such as reducing carbohydrate intake and increasing exercise, as well as the use of drugs such as metformin and sometimes insulin. That’s what it means. The goal is to lower your hemoglobin A1c, a measure of average blood sugar levels over a 3-month period, to below 7%.

“Despite our best efforts and administering hundreds of units of insulin per day, we have had patients who were unable to keep their A1cs below 10%,” Tan said. “Then, after bariatric surgery, he will be able to maintain his A1c levels below the diabetic range without medication. And as he loses weight, he will be able to be more active, the researchers note. ”

Further research is needed to compare the clinical outcomes and cost-effectiveness of weight loss surgery and newer generation antidiabetic drugs such as Ozempic and Munjaro, the editorial states.

Dr Tan said weight loss after surgery is key to improving diabetes outcomes and heart health. Losing weight improves your body’s response to insulin, reduces inflammation, and lowers blood pressure and cholesterol. It can also improve arthritis, allowing you to exercise more, she added.

The results of this study also support the benefits of weight loss surgery for heart health. People in the surgery group had significantly higher HDL, or “good” cholesterol, and lower triglycerides, a type of fat that can increase the risk of heart disease and stroke.

Tan said many people are hesitant to undergo weight loss surgery despite its many benefits because it is invasive and carries risks.

The study found that gastrointestinal complications such as anemia (lack of healthy red blood cells), bone fractures, abdominal pain, nausea, and vomiting were more common in people who had weight loss surgery.

These known complications are caused by nutritional deficiencies that can occur if the gastrointestinal tract is surgically altered. Mr Tan said people undergoing surgery should change their diet and take vitamins regularly to avoid these problems.

Even people who have had surgery can regain the weight they lost, Tan added.

“Even after surgery, it is possible for patients to regain weight if they return to their previous eating habits and portion sizes,” she says.

The study found that 51% of surgically treated participants achieved complete remission of type 2 diabetes after one year, but only 18% remained in remission after seven years. The editorial says that the decreased remission after surgery, which has also been observed in previous studies, is likely due to a combination of weight gain and a decrease in insulin-producing cells over time.

Even short-term remission of diabetes has benefits in terms of reducing diabetes-related complications such as eye, kidney, and peripheral vascular disease, the editorial says.

The initial cost of bariatric surgery is higher than medical management, about $33,000 before insurance, but it is thought to become more cost-effective about five years after surgery, the editorial said.

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