Bariatric Surgery Bests Medical Therapy for Diabetes Remission

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Bariatric surgery seems to be more effective for diabetes remission.
Bariatric surgery seems to be more effective for diabetes remission.

(HealthDay News) — Surgery is more effective than medical control for diabetes remission, with predictors including lower baseline glycemia and shorter diabetes duration, according to research published in Diabetes Care.

Simona Panunzi, PhD, from BioMatLab in Rome, and colleagues examined predictors of diabetes remission among 727 patients from the Swedish Obese Subjects study and 2 randomized controlled trials (415 surgical and 312 medical patients). Bariatric operations were classified as gastric only (GO) and gastric plus diversion (GD).

The researchers found that 64% and 15% of patients in the surgical and medical arms, respectively, experienced diabetes remission (P<.001). GO and GD yielded 60% and 76% remission, respectively. Lower baseline glycemia and shorter diabetes duration were the best predictors of diabetes remission. 

GD predicted higher likelihood of remission and greater weight loss when operation type was considered. Compared with nonresponders, patients in remission (responders) lost more weight (25% vs 17%) and waist circumference (18% vs 13%) and experienced better insulin sensitivity.

"Surgery is more effective than medical treatment in achieving diabetes remission and tighter glycemic control," the researchers wrote. "The results show the advantage of an early operation together with better controlled glycemia on diabetes remission independently of body mass index."

Disclosure: Several authors disclosed financial ties to the pharmaceutical and nutrition industries.

Reference

  1. Panunzi S, Carlsson L, De Gaetano A, et al. Determinants of Diabetes Remission and Glycemic Control After Bariatric Surgery. Diabetes Care. 2015;doi:10.2337/dc15-0575.
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