Surgical cure for type 2 diabetes

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Along with the increased prevalence of obesity, Americans have seen a coincident surge in the incidence of type 2 diabetes mellitus (T2DM). While there are numerous pharmaceutical treatments available, weight loss is seen as perhaps the most effective means of both preventing and treating the condition. As anyone who has tried to shed even a few pounds knows well, substantial weight loss is often difficult to attain and maintain. Perhaps the most effective means of achieving significant weight loss is bariatric surgery, and a recent study suggests that it may also be an effective treatment for T2DM.

In a preliminary report, Dr. Stacy Brethauer and colleagues at the Cleveland Clinic presented data they obtained from 217 patients with T2DM who underwent some form of bariatric surgery. They followed the patients for a median of six years post-surgery to see if they had remission of their disease.

Overall, half of the patients achieved either a partial or complete remission. The parameters examined were glycated hemoglobin (an indicator of long-term blood glucose control) and a fasting blood glucose level between 100 and 125 mg% for at least one year without the use of anti-diabetes medications. In addition, 34% of the patients who did not meet the criteria for continued remission still had significant improvement in blood glucose control six years after surgery.

Bariatric surgery is currently indicated for those with a BMI of 40 or above, but for those with a comorbidity such as diabetes, individuals with a BMI of 35 40 would also qualify.

The authors cautioned that their results should be considered preliminary, since they have not yet been peer-reviewed, and the trial was not a randomized controlled trial. ACSH s Dr. Ruth Kava noted, however, Although not the final word, this study supports the use of bariatric surgery as a means of helping the obese to both lose weight and treat diabetes. It would be interesting to know if the benefits were greater in those who underwent the surgery earlier in the course of their T2DM.