When we consider the treatments for Type 2 diabetes, one would wonder whether surgery, with all its risks and complications is better than the standard treatment. Some surgeons and experts are trying to emphasize that surgery is a better cure than standard treatments while other experts claim that more research is required in this area.
Studies have shown that weight-loss operations or otherwise called bariatric surgery is more effective than the standard remedies for Type 2 diabetes patients who suffer from obesity and have an uncontrolled blood sugar. Those who underwent a bariatric surgeryare more likely to have a diminution of diabetes, or need lesser medication, than patients who were given the typical course of medication,specific diet and exercise. The surgery was also conducive in lowering their blood pressureand cholesterol.
The New England Journal of Medicine has published two new studies, which are the first to rigorously compare medical treatment with bariatric surgery as ways to regulate diabetes. Doctors have noticedover the last few years that weight-loss operations could sometimes completely cure Type 2 diabetes. But they had no hard data to support the cause.
Type 2 diabetes is often linked to obesity and becomes difficult to control as it progresses. It leads to complications such as heart disease, strokes, impaired vision, amputations and kidney failure.
Statistics from the Centers for Disease Control and Prevention show that the number of diabetes cases in the United States has tripled in the last 30 years to more than 20 million. Most of the cases are Type 2.
The different types of weight loss surgeries used in the studies that help control diabetes is not just because they make people lose weight, butalso because it changes in anatomy of the stomach and reduces the level of hormones that affect the metabolism of sugars and fats.
Studies by the Catholic University in Rome have compared two types of surgery with standard medical treatment. After 2 years, the surgical groups had complete reduction rates of 75 percent and 95 percent; patients who received medical treatment had no remissions.
The studies show that the new results will have a major effect on diabetes treatment, and operations might be considered earlier in the treatment of obese patients with Type 2 diabetes. Also it was noticed that the surgeries in these studies were performed by highly skilled surgeons, hence the success rate of the surgery is highly dependent on the expertise of the surgeon. There were no deaths in the studies, but there were complications suchas infection from surgery, nutritional deficiencies and other surgical problems that required repeat operations.
According to the American Society for Metabolic and Bariatric Surgery, about 200,000 bariatric operations are performed every year in the United States, and cost varies from $11,500 to $26,000. Some insurers cover them. Patients may lose 100 pounds or even more after the surgery. Patients are required to follow a strict diet and exercise regime post-surgery to control weight gain.
According to the guidelines from the National Institutes of Health, patients with a body mass index, or B.M.I. over 40, or over 35 and has a medical condition associated with obesity such as Type 2 diabetes can opt for bariatric surgery.
A study in Rome was conducted on 60 patients between ages 30 to 60, with a B.M.I. of 35 or more. They underwent either gastric bypass surgery or biliopancreatic diversion. The bypass patients had a 75 percent remission rate, and the biliopancreatic group, 95 percent. But the biliopancreatic group had more nutritional problems.
The Cleveland Clinic study was conducted on 150 patients ages 20 to 60, with B.M.I.’s from 27 to 43 who underwent either a gastric bypass or sleeve gastrectomy. The gastric bypass patients had a higher remission rate, 42 percent, than those with gastrectomy, 37 percent.The remission rates tend to be lower when patients have advanced Type 2 diabetes.
Patients are advised to understand the different types of surgeries, the risks and complications associated with it and the permanent lifestyle changes that are required post-surgery, before opting for surgery. Also consult your doctor to know which surgery is right for you.
