Bariatric surgery — also known as metabolic or weight-loss surgery — leads to a sense of better general health and an improved quality of life compared with intensive medical therapy for type 2 diabetes, according to a new study presented at the virtual American Surgical Association annual meeting, and reported by Healio.
Bariatric surgery comes in many forms — with gastric bypass probably the best known procedure, which involves surgically reducing the size of the stomach to a small pouch. Other forms of bariatric surgery include sleeve gastrectomy, in which the size of the stomach is reduced to resemble a tube or sleeve. A large body of evidence supports bariatric surgery as an effective treatment for type 2 diabetes in people who are obese, and shows that it can drastically improve blood glucose control even before someone loses weight. In many cases, people see their diabetes effectively resolved and don’t need to take any medical treatments to maintain healthy blood glucose levels.
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For the latest study, researchers were interested in the effects of bariatric surgery on general health and self-reported quality of life in people with type 2 diabetes who underwent the procedure. The researchers used data from a trial called STAMPEDE (Surgical Treatment and Medications Potentially Eradicate Diabetes Efficiently), which randomly assigned 150 participants either to undergo bariatric surgery or to receive intensive medical therapy for their diabetes. The main endpoint for that trial was achieving an A1C level (a measure of long-term blood glucose control) below 6.0% without taking any diabetes medications, indicating that a person’s diabetes is effectively resolved. In the original five-year follow-up for that trial, diabetes was resolved in 5% of participants who underwent only medical therapy, 29% of those who underwent gastric bypass, and 23% of those who underwent sleeve gastrectomy.
In the latest study, researchers found that participants who underwent bariatric surgery reported having more energy, less fatigue, and better health in general than those who received only medical therapy for their diabetes. While participants who underwent surgery reported improvements in these areas since before their procedure, “None of the quality of life components improved significantly from baseline in the intensive medical therapy group,” the researchers wrote in a summary. The factors most likely to be linked to an improved perception of general health included having better health before the surgery, as well as not needing to take insulin five years later.
Perhaps surprisingly, though, there weren’t any significant differences between the bariatric surgery and medical therapy groups in terms of psychological or social aspects of quality of life. The researchers noted that these aspects of health may require more attention from healthcare providers in people with diabetes who undergo bariatric surgery.
Want to learn more about bariatric surgery and Type 2 diabetes? Read “Is Bariatric Surgery for You?” and “Bariatric Surgery and Diabetes: Questions and Answers.”
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