Evidence Weight-Loss Surgery Helps Against Diabetes
One-third of gastric-bypass patients kept type 2 diabetes under control without meds during three-year study
The current study included 150 people with type 2 diabetes. Their average age was 49, and two-thirds were female. At the start of the study, the patients' average body-mass index (BMI) -- a rough estimate of a person's body fat -- was nearly 37. Below 25 is considered normal weight and over 30 is considered obese, according to the U.S. Centers for Disease Control and Prevention.
One-third of the study volunteers were randomly selected to receive standard medical management of their type 2 diabetes, while another third was given gastric-bypass surgery and medical management. The final third received sleeve gastrectomy plus medical management of their diabetes.
Gastric-bypass surgery routes food directly to the small intestine, which means it bypasses the stomach, duodenum and large intestines, according to the NIDDK. Sleeve gastrectomy reduces the size of the stomach.
Kashyap said the biggest benefits of the surgeries likely stem from the amount of weight lost. "When you're taking drugs to manage diabetes, it's hard to lose significant amounts of weight," she said. "A lot of diabetes medications make weight loss hard."
Weight-loss surgery costs about $25,000 to $30,000, Kashyap said, and requires about two to four weeks time off of work. Insurance companies generally pay for the procedure only for people who have a BMI over 35, she said.
Because experts at the Cleveland Clinic believe weight-loss surgery can be beneficial for people with lower BMIs who also have other health problems, such as type 2 diabetes, their insurance program pays for the procedure in people with BMIs as low as 30, Kashyap said.
Although weight-loss surgery can help some people, however, it might create new problems, according to an expert not involved in the study.
"This study reassures that these procedures work, and may be worth trying in some patients," said Dr. Joel Zonszein, director of the clinical diabetes center at Montefiore Medical Center, in New York City. "But they're not ... a cure. You're changing one disease (type 2 diabetes) for another (malabsorption)."
Malabsorption -- nutrients being poorly absorbed in the body -- can be a later effect of weight-loss surgery, according to the NIDDK.
Still, Zonszein said, in people who don't respond well to type 2 diabetes medications or who don't tolerate them well, "they may do much better with surgery. We really have to look at each patient independently."