Will Surgery be the New Cure for Diabetes?
Operations for Weight Loss Can Have an Effect on Diabetes Resolution
Oct 18, 2009
The use of bariatric surgery as a potential cure for Type II Diabetes was reviewed during a dedicated symposium at the European Association for the Study of Diabetes (EASD) annual meeting held in Vienna, Austria in October 2009.
The word "bariatrics" - from the Greek baros (weight) and iatrikos (pertaining to the treatment) - describes that branch of medicine which deals with obesity. Bariatric surgery refers to those surgical operations which are performed on the stomach and intestines of people who are overweight with the objective of helping them to lose weight.
"Bariatric surgery," observes Lars Sjöström, Professor of Clinical Research at the Department of Medicine of Göteborg University in Sweden, "is a very favourable option in the treatment of obesity, particularly in obese subjects with pre-diabetes and diabetes.”
Swedish Obese Subjects (SOS) Study
Sjöström presented findings from the Swedish Obese Subjects (SOS) study, which evaluated the effect of weight-loss surgery on mortality and other outcomes such as the development of, as well as the recovery from, diabetes.
The research analysed the impact of weight loss surgery on 2010 middle-aged obese patients with an average Body Mass Index (BMI) of approximately 42 compared with 2037 control patients.
The study found that significantly fewer individuals in the group of patients studied who underwent weight-loss surgery developed Type II diabetes when compared to those who did not undergo surgery.
Lifestyle Changes Reduce Incidence of Diabetes
Lifestyle changes have been shown to substantially reduce (by 37–45%) the likelihood that individuals with pre-diabetes will go on to develop Type II diabetes - but bariatric surgery was demonstrated to be even more efficacious, reducing the incidence of Type II diabetes by 86% after two years and by 75% after 10 years. However, while altering one's lifestyle can reduce the incidence of new diabetes, lifestyle changes have virtually no possibility of "curing" diabetes once the disease is established.
“Lifestyle changes, even if accompanied by the use of drugs to induce weight loss, have very modest effects on body weight - and almost no effect on diabetes resolution - in these obese patients,” Sjöström claims. "In contrast, bariatric surgery was shown to have a dramatic effect on both weight loss and diabetes resolution."
Long Term Weight Loss
The incidence of Type II diabetes has been shown to be much more closely related to recent weight changes than to a person's level of obesity. It was also demonstrated that although blood sugar control can be significantly improved for up to four years with small changes in body weight, at least 15 kg needs to be lost, and the weight loss maintained, in order to have a long-term (10 year) effect on an individual's blood glucose level.
"Bariatric surgery for severe obesity," concludes Sjostrom, "is associated with long-term weight loss and decreased overall mortality. It can produce very good outcomes in not only obese people at risk of developing Type II diabetes but also in those who have already developed diabetes."
 |
