Bariatric surgery can produce significant long-term metabolic benefits for insulin-treated patients with type 2 diabetes, new research indicates.
Findings from the retrospective analysis of data for over 250 patients, which represents the largest series with the longest follow-up time to date, were presented November 2 here at Obesity Week 2017 by Ali Aminian, MD, associate professor of surgery at the Cleveland Clinic, Ohio.
“Seven years after bariatric surgery, 44% of patients could come off insulin with their glycemic control at the target. Discontinuation of insulin can have significant impact on quality of life and healthcare costs,” Dr Aminian told Medscape Medical News.
For the 194 patients who underwent Roux-en-Y gastric bypass and 58 given sleeve gastrectomy, the surgeries also produced significant improvements in blood pressure and lipid profiles. And while gastric bypass was associated with more weight loss, less weight regain, and better short-term diabetes control, long-term diabetes control was similar between the two procedures.
Asked to comment, session moderator Shanu N Kothari, MD, director of the minimally invasive bariatric surgery program at Gundersen Health System, La Crosse, Wisconsin, told Medscape Medical News that the new data “add to our body of literature that we have a metabolic intervention that’s underutilized that gives far more durable and successful outcomes than medications.”
Dr Kothari added, “One message from this is that we should be intervening sooner. We know the chances of remission are much higher when we intervene with either procedure sooner as opposed to later…preferably for patients with type 2 diabetes before they get to the point where they’re on insulin, because as the diabetes duration and severity increases over years, the pancreatic reserve goes down.”
Source: Bariatric Surgery: Many Can Come Off Insulin Long Term – Medscape – Nov 06, 2017.