Bariatric Surgery More Effective in Achieving Remission in T2D

Recent data has demonstrated that bariatric surgery may be more effective in the remission of type 2 diabetes (T2D) than medication and lifestyle changes.

The researchers aimed to determine the durability of metabolic surgery and its effectiveness in patients with T2D compared with medical and lifestyle management, the typical health care strategy for individuals with the disease.

Data was used from various clinical trials in this prospective observational cohort of patients with T2D (n = 316). The cohort was divided into 2 groups of patients who were previously randomly assigned to bariatric surgery (n = 195) and patients who used medical/lifestyle therapy (n = 121). The primary outcome of the study was the rate of diabetes remission (hemoglobin A1c [HbA1c] ≤ 6.5% for 3 months without usual glucose-lowering therapy). Additionally, the researchers looked at glycemic control, body weight, biomarkers, and comorbidity reduction as secondary outcomes.

The results of the study show that T2D remission was achieved in more patients following surgery (60 of 160 [37.5%], P < .001) when compared with those who utilized medical/lifestyle therapy (2 of 76 [2.6%], P < .001).

Furthermore, reductions in HbA1c, fasting plasma glucose, and BMI were observed after surgery and were greater than in patients who underwent surgery. Additionally, the researchers saw a lower percentage of patients using medications to control diabetes, hypertension, and dyslipidemia after surgery (P < 0.001).

The researchers also noted that these results were consistent among individuals with class I obesity, in which surgery is not widely utilized.

“In summary, prospective randomized interventional data from the largest cohort of patients to date demonstrates that metabolic surgery improves glycemic control, diabetes-related comorbidities, and weight loss to a greater extent than medical/lifestyle intervention for up to 3 years after treatment, with minimal and generally tolerable [adverse events],” the researchers concluded.

—Jessica Ganga

Reference:

Kirwan JP, Courcoulas AP, Cummings DE, et al. Diabetes remission in the alliance of randomized trials of medicine versus metabolic surgery in type 2 diabetes (ARMMS-T2D). Diabetes Care. 2022;45(7):1574-1583. doi:10.2337/dc21-2441.