Bariatric surgery’s impact on type 2 diabetes

Researchers recently published an article in the Journal of the American Medical Association (JAMA), following the journeys of individuals battling type 2 diabetes over an impressive 11-year period. The study focused on comparing the outcomes of two treatment approaches: bariatric surgery versus medical management.

Among the 262 patients involved, with an average age of 50 and a mean body mass index (BMI) of 36 kg/m2, the findings were striking.

Firstly, after 7 years, those who underwent bariatric surgery experienced a remarkable reduction in their average glycosylated haemoglobin (HbA1c) levels compared to their counterparts undergoing medical management. This decline signified better blood sugar control among those who opted for surgery.

Interestingly, both Roux-en-Y gastric bypass and sleeve gastrectomy emerged as equally effective procedures, outperforming gastric banding in terms of weight loss over the 12-year period.

Moreover, the study revealed that while bariatric surgery initially led to higher rates of diabetes remission, the gap gradually narrowed over time. By the 12-year mark, fewer patients maintained remission, suggesting a need for ongoing monitoring and support.

One of the most striking revelations was the impact on medication use: a significant proportion of patients who underwent surgery were able to discontinue their diabetes medications, contrasting sharply with the persistent need for medication among those receiving medical management.

Importantly, both treatment groups experienced low rates of major adverse cardiovascular events. However, patients who underwent surgery were more susceptible to gastrointestinal symptoms and nutritional deficiencies, highlighting the importance of comprehensive post-operative care.

Overall, this study underscores the potential of bariatric surgery as a long-term solution for individuals grappling with type 2 diabetes, offering sustained weight loss and improved glycemic control. Yet, it also underscores the need for informed decision-making, thorough patient education, and vigilant post-operative care to mitigate potential risks and ensure optimal outcomes.