Surgery May Beat Medication for Type 2 Diabetes

The battle against type 2 diabetes may be moving from the pharmacy to the operating table, according to new research published in the New England Journal of Medicine.  A combined study from researchers in Rome, Italy and New York indicates bariatric surgery for weight loss may be more successful at controlling type 2 diabetes than standard treatments including medications.

Millions of Americans have diabetes, and many more are at high risk for the disease.  Diabetes results when excess sugar or glucose builds up in the blood.  This may be due to the body’s inability to produce insulin, which is a hormone required by cells to draw glucose out of the bloodstream, or may be because cells become resistant to insulin.

Type 2 diabetes, which is the most common type, is traditionally treated using medications to help the body reduce blood sugar levels by boosting insulin production.   In more serious cases, insulin injections may also be required to treat type 2 diabetes.

Researchers at Catholic University / Policlinico Gemelli in Rome, Italy and New York-Presbyterian/Weill Cornell Medical Center studied the effects of bariatric or weight loss surgery on type 2 diabetes.  The researchers concluded that surgery was significantly better at reducing type 2 diabetes symptoms than traditional treatments.  Most participants in the study who had bariatric surgery were able to stop taking diabetes medications soon after surgery and remained free from diabetes through the 2 year follow-up period.  In contrast, none of the patients on standard treatment was able to stop taking medications.

"Although bariatric surgery was initially conceived as a treatment for weight loss, it is now clear that surgery is an excellent approach for the treatment of diabetes and metabolic disease," said senior author Dr. Francesco Rubino, chief of Gastrointestinal Metabolic Surgery and director of the Metabolic and Diabetes Surgery Center at NewYork-Presbyterian/Weill Cornell and associate professor of surgery at Weill Cornell Medical College.

Type 2 diabetes is historically difficult to treat in obese patients. Being overweight is a key contributor to type 2 diabetes. At the same time, the therapies used to treat diabetes often cause additional weight gain, which makes it harder to get control of the disease.

Two years after surgery, 95 percent of study participants who underwent bilopancreatic diversion surgery no longer needed medicine to manage diabetes because the condition was in full remission.   75 percent of patients who had Roux-en-Y gastric bypass surgery were also in remission and not taking medication after two years.  Of the remaining study participants who were only treated with standard medications, none was in remission and all still required medication after two years.

Currently patients must have a body mass index (BMI) of 35 or more to be considered for bariatric surgery.  The research team suggested that if their findings are confirmed, a new method to determine who should qualify for bariatric surgery may be appropriate. The research team recognizes that their study group was small and further studies are needed to confirm their results.  Further follow-up is also needed to confirm that diabetes remains in remission more than two years after weight-loss surgery.

The research study was funded by the Catholic University of Rome, Italy.

Denise DeWitt is a freelance writer for


Science Daily. Bariatric Surgery Dramtically Outperforms Standard Treatment for Type 2 Diabetes. Web. April 6, 2012.

New England Journal of Medicine. Bariatric Surgery versus Conventional Medical Therapy for Type 2 Diabetes.  Gertrude Mingrone, MD et al. Web. April 6, 2012.

New York Times. Surgery for Diabetes May Be Better Than Standard Treatment. Denise Grady. Web. April 6, 2012.

Medical News Today. Bariatric Surgery Better Than Standard Therapy For Type 2 Diabetes Patients.  Grace Rattue. Web. April 6, 2012.

American Diabetes Association. Diabetes Basics: Type 2. Web. April 6, 2012.

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