Surgery better for diabetes in the obese

Two clinical studies suggest that gastric surgery is better than traditional methods of care for controlling diabetes in overweight and obese patients.

The first study, nicknamed Stampede, and presented at the American College of Cardiology conference in Chicago, showed that patients who had operations fared three to four times better than those who did not after one year.

The study followed 150 patients who were randomly assigned to surgery or regular medical care, including drug regimens. Their starting body mass indexes ranged from 27, or overweight, to obese at up to 42 BMI.

Those who got surgery saw significant improvements in blood sugar, or glycaemic control, and were able to cut down on the number of medications they took, while those in the medical group tended to take more drugs than before with less effect.

Forty two per cent of people who had a laparoscopic gastric bypass and nearly 37 per cent who had a sleeve gastrectomy achieved a lowering of blood sugar known as glycaemic control, or a haemoglobin HbA1c level of six per cent.

The second study based in Rome, Italy, enrolled 60 people age 30-60 with a body mass index of 35 or higher and a history of type 2 diabetes. They were randomly assigned to one of two types or surgery, or intensive medical counselling.

After two years, the study found that “bariatric surgery resulted in better glucose control than did medical therapy.”

Fifteen of the 20 patients who had surgery saw their diabetes go into remissin..

Gastric bypass surgery is a two-step operation that reduces the stomach to the size of a golf ball and then connects this smaller pouch to the intestines.