Many of you may have read or heard about an important study published in the New England Medical Journal on March 26, 2012. Dr. Phil Schaur and his colleagues at the Cleveland Clinic completed a trial that has very profound implications for patients with Type 2 diabetes.
They compared 50 poorly controlled diabetic patients who had intensive medical management of their diabetes to 50 patients treated with a laparoscopic gastric bypass plus medical therapy and another 50 patients who were treated with a laparoscopic gastric sleeve plus medical therapy.
There was no mortality and complications were low.
The primary finding was that at the end of 1 year the patients who had surgery plus medical therapy achieved much better control of their diabetes. In fact, nearly 4 times as many patients in the surgery plus medical therapy group achieved excellent diabetic control than the group receiving only intensive medical therapy.
Between the two surgical options, the laparoscopic gastric bypass patients did somewhat better than the laparoscopic gastric sleeve patients.
Another important finding was that those receiving only intensive medical therapy increased the number of medicines they had to take over the year while those who had surgery plus medical therapy decreased the number of diabetic medicines and often were on no diabetic medicines at all.
Although it will be helpful to continue to follow these patients for several more years to evaluate the long term effects of better control, it is very clear that patients with type 2 diabetes do better if they have bariatric surgery than those who do not choose to have surgery.
Several months ago I mentioned that the medical establishment was too slow in accepting the remarkable improvement in diabetes after bariatric surgery. Could there be a sea change coming with this and other studies?
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