Bariatric Surgery as First-Line Diabetes Treatment Leads to High Rates of Remission in Patients With Obesity Class 1, 2
By Kerry Young
OXON HILL, Md -- November 4, 2017 -- Bariatric surgery caused a notable rate of type 2 diabetes remission for people at the lower end of the obesity scale who were recently diagnosed with the disease, according to a study presented here at Obesity Week 2017, the joint Annual Meeting of the American Society for Metabolic & Bariatric Surgery (ASMBS) and The Obesity Society (TOS).
In a long-term follow-up study, 31 of 35 (89%) patients met the criteria of diabetes remission, reported Ali Aminian, MD, Cleveland Clinic, Cleveland, Ohio. Previous research has found that long-term diabetes remission after bariatric surgery is usually seen in only one-third of patients.
“However, if we perform surgery as the first-line treatment of diabetes in patients who are not severely obese, almost 90% would have diabetes remission,” said Dr. Aminian.
The study tracked people who fell into obesity class 1 and 2 (body mass index [BMI], <40 kg/m2) and had been diagnosed with type 2 diabetes within 12 months of their surgery. The group had a mean baseline BMI of 37.8 and a mean age of 40.5 years.
The criteria for diabetes remission in the study was a haemoglobin A1C (Hb A1C) level of <6.5% and fasting blood glucose (FBG) <126 mg/dL while off diabetes medications.
Roux-en-Y gastric bypass was the most common treatment (n = 27), followed by sleeve gastrectomy (n = 6), and gastric banding (n = 2).
With a median follow-up of 5 years, a mean BMI reduction of 7 ± 4 kg/m2 and a median excess weight loss of 55% appeared to have led to a significant mean reduction in Hb A1C (7.1 ± 1.5 vs 5.8 ± 0.5%; P< .001), FBG (129.4 ± 53.8 vs 94.6 ± 15.7; P = .001), and diabetes medication requirement (0.7 ± 0.6 vs 0.06 ± 0.2; P< .001).
At this point, 31 out of 35 patients met the remission criteria, with only 2 patients still taking diabetes medications. Another patient had Hb A1C >7% at the last follow-up.
[Presentation title: Bariatric Surgery as a First Line Treatment of Type 2 Diabetes in Patients With Obesity Class I and II: 89% Diabetes Remission in Long-Term Follow-Up. Abstract A5148]