|
 Five years later, 27 percent of the people who achieved remission
had relapsed, the study also found. However, the total proportion of
people in remission held steady, suggesting that some people
achieved remission later and remained free of diabetes symptoms.
"We have known for some years from smaller studies . . . that
Roux-en-Y gastric bypass surgery has the ability to make type 2
diabetes go into remission, meaning freeing patients from the use of
glucose-lowering drugs," said lead study author Dr. Lene Ring Madsen
of Aarhus University in Denmark.
"The novelty of our study is that we can confirm these results in
large real-world cohorts of unselected patients with severe obesity
and type 2 diabetes," Madsen said by email.
Gastric bypass reduces the size of the stomach from about three
pints to roughly the size of a shot glass.
In the current study, researchers examined data on 1,111 people with
type 2 diabetes, the more common form that's associated with obesity
and aging. All the patients had Roux-en-y gastric bypass procedures
between 2006 and 2015.
Patients were more likely to achieve diabetes remission after
surgery when they were younger, had been living with diabetes for
shorter periods of time, and had less severe diabetes. Men also did
better than women.
Within six months of surgery, 65 percent of patients had their
diabetes go into remission. This rate rose to 74 percent over the
next six months and remained there for the rest of the study period.
Diabetics who were taking insulin before their weight-loss surgery
had 43 percent lower remission rates than patients who didn't need
insulin, the study also found.
Compared to 1,074 similar obese patients with type 2 diabetes who
didn't have RYGB surgery, those who did were less likely to develop
so-called microvascular complications like kidney or eye problems
caused by diabetes. With surgery, the risk of eye damage was 48
percent lower and the chance of kidney disease was 46 percent lower.
[to top of second column] |
Within 30 days of surgery, 7.5 percent of patients had repeat
hospitalizations for complications related to the gastric bypass
procedures.
The study, reported in Diabetologia, wasn't a controlled experiment
designed to prove whether or how weight-loss surgery might help
people control diabetes symptoms or reduce the need for diabetes
medications.
Even so, the results suggest that obese people with diabetes may not
necessarily want to wait to have surgery if they're considering this
option, since their chance of remission goes down the longer they
live with diabetes, said Dr. Sheri Colberg of Old Dominion
University in Norfolk, Virginia.
"The earlier after diabetes diagnosis that gastric bypass surgery is
done, the greater its potential impact on preventing many
diabetes-related health complications," Colberg, who wasn't involved
in the study, said by email.
"Given that it involves major abdominal surgery, having a gastric
bypass procedure is certainly not without some major health risks,
including short-term complications from the surgery itself and
longer-term ones like micronutrient deficiencies due to
malabsorption of vitamins and minerals in the diet," Colberg added.
"This study does suggest that more than half of patients undergoing
such surgeries were able to remain diabetes-free, which reduces
their risk of the long-term health complications associated with
diabetes," Colberg said. "Patients who are unable to lose weight any
other way may benefit more than those who can lose weight (and
reverse diabetes or limit its impact) via adopting a healthier
lifestyle -- it will need to be an individual choice and is
certainly not for everyone."
SOURCE: http://bit.ly/2UePjdZ Diabetologia, online February 6, 2019.
[© 2019 Thomson Reuters. All rights
reserved.] Copyright 2019 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
Thompson Reuters is solely responsible for this content. |
