Weight-loss surgery could prevent diabetes
When it comes to postponing the onset of type 2 diabetes in obese individuals, weight-loss surgery was found to be more effective than diet and exercise alone, according to recent study published in the New England Journal of Medicine. The study followed 3,400 obese men and women over 15 years and found that bariatric surgery reduced their risk for developing type 2 diabetes by 78 percent, reported ABC News.
According to Reuters, 346 million individuals worldwide have diabetes, and approximately 90 percent of these have type 2, commonly linked to obesity and lack of exercise. Lifestyle changes and prescription weight-loss drugs have been shown to decrease the risk for developing diabetes by 40 to 45 percent.
This study, led by Dr. Lars Sjöström of Sahlgrenska University Hospital, was one of the first to examine whether weight-loss surgery could prevent the onset of diabetes. Other recent studies revealed that surgery can successfully reverse diabetes in people who already developed it, noted The Huffington Post.
The study began in 1978, at which time none of the participants had diabetes. Each individual selected one of two treatment options: to have surgery in the form of stomach stapling, gastric banding or gastric bypass, or to undergo a plan considered typical for such patients: counseling that promoted healthier eating and increased exercise. According to The Huffington Post, 1,658 participants elected for the surgery and 1,771 patients opted for the counseling. The latter were considered the study's control group.
Ten years into the study, researchers found that 110 participants in the surgical group and 392 participants in the counseling group developed diabetes. Researchers also discovered that after 15 years the overall weight loss in the surgical group averaged 44 pounds but only averaged seven for the control group. Results showed the annual risk for developing diabetes in the surgery group was 1 in 150 while it was 1 in 35 for those in the control group.
"This is terrific data for decreasing the epidemic of diabetes," Dr. Carson Liu, a bariatric surgeon in Los Angeles, told ABC News.
The results of the study have the potential to to increase the number of people eligible for surgery under health insurance; often, health insurance companies cover only those who are overweight with health-related issues or those who are obese. The study could also lead to a drop in the acceptable body mass index, or BMI, needed to qualify for surgery.
"The threshold for metabolic surgery has been (a BMI of) 35 for many years, like a brick wall," Dr. Philip Schauer, director of the Bariatric and Metabolic Institute at the Cleveland Clinic, said to ABC News. "But that brick wall is like the Berlin Wall, it's coming down. Thirty is potentially the new wall."
Dr. Danny Jacobs, a Duke University surgeon, described the results as 'exciting' in The Huffington Post, but also said surgery would be an 'impractical and unjustified' way to treat the million of people with diabetes. Bariatric surgery can be expensive, often costing between $15,000 to $25,000.
Bariatric surgery also has potential risks: in rare cases, it can lead to blood clots, infection and ulcers. Indeed, two to five percent of the participants in the surgical group developed complications and three patients died within 90 days following surgery, according to Reuters.
There is also the chance that more of the participants in the surgical group could become diabetic in the future.
"Some of those surgical patients will probably develop diabetes later, but over a lifetime, there will be a large difference," Sjöström said in Reuters.
"Bariatric Surgery Can Help Prevent Diabetes: Study," huffingtonpost.com, Marilynn Marchione, Aug. 22, 2012
"Weight Loss Surgery Cuts Diabetes Risk," abcnews.go.com, Dr. Tiffany Chao, Aug. 23, 2012
"Weight Loss Surgery Helps Prevent Diabetes: Swedish Study," reuters.com, Gene Emery, Aug. 22, 2012