Bariatric surgery outperforms traditional treatments for long-term diabetes control

By Dr. Sushama R. Chaphalkar, PhD.Feb 28 2024Reviewed by Susha Cheriyedath, M.Sc. In a recent study published in the Journal of American Medical Association , researchers from the United States of America compared the safety, efficacy, and long-term outcomes of bariatric surgery and medical and lifestyle management in patients with type 2 diabetes mellitus .

Background T2DM affects over 500 million adults globally, presenting significant economic burdens. Although bariatric surgery has shown superiority over medical and lifestyle therapies in treating the condition, limited randomized controlled trials with constraints in sample size and follow-up duration have hindered widespread recommendations. This has led to less than 1% of individuals with a body mass index of 35 kg/m2 or higher considering surgical treatment.

About the study The study included 262 T2DM patients with a BMI of 27–45 kg/m2. The mean age was 49.9 years, and 68.3% of them were female. Patients were randomized to undergo intensive medical and lifestyle management , or bariatric surgery , and postoperative care . Based on self-reported racial information, about 31% of patients were Black, and 67.2% were White. While the study was conducted between 2007 and 2013, the observational follow-up was conducted until 2022.

Results and discussion In spite of higher baseline values, the bariatric surgery group consistently maintained significantly lower HbA1c levels than the medical group, with a difference of -1.4% and -1.1% at seven years and 12 years, respectively. At seven years, HbA1c improvements were similar between Roux-en-Y gastric bypass and sleeve gastrectomy, while adjustable gastric banding showed less improvement than sleeve gastrectomy and Roux-en-Y gastric bypass .

Source: Healthcare Press (healthcarepress.net)

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