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

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.