|
 "One of the most important things to take away is that there is
durability of remission over time," said Dr. Anita Courcoulas of the
University of Pittsburgh Medical Center, who led the research.
Past studies have found that weight loss surgeries sometimes result
in improvement for people with type 2 diabetes, but it remains to be
seen if the surgeries are better at treating the condition than
lifestyle interventions, the researchers write in JAMA Surgery.
And few studies have examined the effectiveness of weight loss
surgery for people with diabetes as well as class 1 or 2 obesity,
which represents a body mass index (BMI) between 30 and 39. (BMI is
a measure of weight in relation to height).
Weight loss surgeries are typically used to treat people with a BMI
of 40 or more, or with a lower BMI but other health conditions.
Approximately 29 million Americans - about 9 percent of the U.S.
population - have diabetes, according to the Centers for Disease
Control and Prevention. About 30 percent of them are undiagnosed.
Type 2 diabetes, the most common form, is often linked to obesity.
In type 2 diabetes, the body doesn't make enough of the hormone
insulin, which helps cells use glucose for fuel, or enough insulin
is produced but cells are resistant to it.
For the new research, the researchers studied 61 people, ages 25 to
55, with type 2 diabetes. About half had class 1 obesity and the
rest were heavier.
Participants were randomly assigned to receive one of three
treatments. One was an intensive lifestyle intervention for one year
to help them lose weight with diet, exercise and behavior changes,
followed by a lower-intensity lifestyle intervention involving
behavioral counseling a few times a month for two years.
Alternatively, participants were assigned to one of two weight loss
surgeries: either Roux-en-Y gastric bypass (RYGB), or laparoscopic
adjustable gastric banding (LAGB). The surgeries were followed by
the same low-intensity lifestyle intervention the non-surgery group
got, for two years.
After three years, 40 percent in the RYGB group, 29 percent in the
LAGB group and no one in the lifestyle intervention group had at
least a partial remission of their type 2 diabetes.
Three people in the RYGB group and one person in the LAGB group had
their diabetes disappear entirely, which did not occur for anyone in
the lifestyle group.
[to top of second column] |
Researchers also found that blood sugar control improved more in the
surgery groups, compared to the lifestyle intervention group. The
surgery groups were also more likely to no longer need medication
for their diabetes.
While the new results are a from a randomized study, which is
considered the "gold standard" of medical research, Courcoulas said
they will need to follow more patients at several medical centers
over a longer period of time to draw definite conclusions.
The researchers are pooling their data with similar studies from
across the country, she added.
"We’ll be able to see what the remissions look like at five and
seven years," Courcoulas said. "I think that’s the next step in this
field."
Dr. Osama Hamdy, who was not involved with the new study, cautioned
that people with type 2 diabetes and their doctors should not get
overly excited about the results.
"Any study like this we need to be very cautious when reading them
and read between the lines," said Hamdy, who is medical director of
the Joslin Diabetes Center Obesity Clinical Program.
For example, Hamdy pointed out, only a handful of people in the
surgery groups had their diabetes disappear. What's more, he said,
newer lifestyle-only interventions can be very effective.
"I’m cautious about this and people have to weigh the risks and
benefits," he said.
SOURCE: http://bit.ly/1HztNpZ and http://bit.ly/1HztOKC JAMA
Surgery, online July 2, 2015.
[© 2015 Thomson Reuters. All rights
reserved.] Copyright 2015 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed. |
