Report: Why Weight-Loss Surgery Is a Good Option for Diabetes Treatment
The world’s leading diabetes organizations say the procedure should be a standard treatment option for people with diabetes — even if they don’t need to lose much weight.
With recent research piling up that surgery designed for weight loss can help people get their type 2 diabetes under control, the world’s leading diabetes organizations say in a report published Tuesday that the procedure should be a standard treatment option for people with diabetes — even if they don’t need to lose much weight.
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Forty-five diabetes organizations from around the world support the treatment guidelines suggested in the report, which appears online in the journal Diabetes Care.
The new guidelines represent a major shift in the way doctors think about the disease.
Surgery to treat diabetes is a radical departure from conventional approaches, which use a combination of diet, exercise and medicine. But fewer than half of adults who take diabetes medicines achieve their therapeutic goals and lifestyle interventions often are disappointing in the long-term, the report says.
On the other hand, research has shown that many people who undergo metabolic surgery experience major improvements in their blood sugar levels, as well as a reduction in cardiovascular risk factors. This makes metabolic surgery a highly effective treatment for type 2 diabetes and a highly effective means of diabetes prevention, the report says.
Metabolic surgery includes sleeve gastrectomy, which removes parts of the stomach, or gastric bypass, which reroutes the small intestine.
These new guidelines are important because they give patients with type 2 diabetes another option when traditional medical therapy doesn’t produce the desired results, says bariatric surgeon Philip Schauer, MD, Director of Cleveland Clinic’s Bariatric and Metabolic Institute.
“Type 2 diabetes is rampant in this country, and is a major killer,” Dr. Schauer says. “It’s the seventh-biggest killer in our country. It is the major cause of blindness, kidney failure and amputations. Despite the fact there has been better drugs developed for treatment fo type 2 diabetes, many patients still are not in good control.”
The goal of the new guidelines is to put more people in control of their diabetes and more people into remission, Dr. Schauer says.
The new report takes into consideration data collected worldwide from more than 11 clinical trials over the past 10 years. Among them was a Cleveland Clinic-led trial that showed people with type 2 diabetes who had bariatric surgery were better able to meet their target blood sugar level goals than those who received traditional medical therapy.
With these new guidelines, bariatric surgery is expected to be recommended as a treatment option for more patients than ever before, Dr. Schauer says. Until now, doctors only considered metabolic surgery for people with a body mass index (BMI) greater than 35 or if they also have other health problems, such as high blood pressure or sleep apnea.
“Even patients with fairly mild obesity — for example a BMI as low as 30 — may be eligible for surgery based on relatively new evidence that suggests these operations are very effective and safe,” Dr. Schauer says. “Advances in surgical methods have made it a low-risk procedure.”
Bariatric surgery treatment guide