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Surgery Works Better Than Drugs at Blood Sugar Control in Obese Patients
An Ohio-based study of overweight and obese type 2 patients shows that weight loss surgery works much better at controlling blood sugar levels than any known drug treatment.
The study, called STAMPEDE and conducted by the Cleveland Clinic, compared results among 150 patients who had body mass indexes ranging from 27 (overweight) to 43 (morbidly obese). Their average HbA1C level was 9%.
Researchers divided the patients into three groups: Two of the groups were randomly assigned one of two types of weight-loss surgical procedures and no diabetes drugs. The third group received drugs but underwent no surgery.
The study goal was to see what percentage in each group achieved an A1c of 6% or lower after one year.
Forty-two percent of patients who underwent laparoscopic gastric bypass surgery, which allows food to bypass part of the small intestine, reached the 6% or lower goal.
Thirty-seven percent of patients who underwent sleeve gastrectomy, which dramatically reduces stomach size, achieved the 6% or lower target.
Twelve percent of patients in the drugs-only treatment group reached the goal.
Currently, gastric bypass surgery is limited to patients with a body mass index of 35 or greater-severely obese. But because many bypass patients are and have been type 2s, surgeons have often noticed dramatic improvements in type 2s' symptoms after the surgeries.
The beneficial effects of the surgeries have created a push among some surgeons and diabetes advocates to make health insurance companies lower the BMI required to qualify a person for bypass surgery coverage. The first part of the push would be lower the qualifying BMI number to 31. A second part would be to extend the bypass surgery option to type 2s on the grounds that the cost of the surgery would be more than repaid by a reduction in the expense of treating type 2s over the course of several decades.
An estimated 80 percent of the 23 million Americans who have type 2 are overweight or obese.
Categories: A1C, BMI, Diabetes, Diabetes, Food, Type 2 Diabetes, Type 2 Issues
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Comments
Actually, the percentage of Type 2s who are overweight/obese is far more than 80 percent. Studies on the 20 percent not obese consistently show that most are auto antibody positive, have Type 1 autoimmune diabetes, and have been misdiagnosed.
Why the Sub-6% A1c Goal? I know that "normal" people have A1c levels that are less than 6%. But, a Type 2 Metabolic Syndrome patient does not have a "normal" metabolism and the medical world does not know which portions of the patient's metabolism are skewed or dysfunctional. The current treatment for Type 2 Metabolic Syndrome patients seems to be a mouthful of meds, some form of bariatric surgery, or a sympathy card.
This says nothing about the "downside" of the surgery. Ok - assuming that the surgery will do a better job of lowering BG than drugs, you have to wonder, "what's the chance that it will kill me?" What's the chance that the effects will be short-term (i.e. not a permanent fix)?
There are many questions about the surgery strategy, and there's a lot of information out there including from people who have had the surgery.
Good point cHanson! This is the typical approach of western medicine - treat the symptom at great cost to the overall health of the person. We need to move to a more holistic system that gets to the root of the problem rather than just balancing blood sugar.
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