{"id":27708,"date":"2012-03-26T14:34:53","date_gmt":"2012-03-26T18:34:53","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=27708"},"modified":"2012-03-26T23:09:15","modified_gmt":"2012-03-27T03:09:15","slug":"bariatric-surgery-turns-back-the-clock-on-diabetes","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2012\/03\/26\/bariatric-surgery-turns-back-the-clock-on-diabetes\/","title":{"rendered":"Bariatric Surgery Turns Back the Clock on Diabetes"},"content":{"rendered":"<p>Two new randomized trials offer evidence that bariatric surgery is highly effective in obese patients with diabetes. The results, according to Paul Zimmet and K. George M.M. Alberti, writing in\u00a0<a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMe1202443?query=featured_home\" target=\"_parent\">an editorial in the\u00a0<em>New England Journal of Medicine<\/em><\/a>, \u201care likely to have a major effect on future diabetes treatment.\u201d<\/p>\n<p>In the STAMPEDE trial, which was presented at the American College of Cardiology and\u00a0<a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1200225?query=featured_home#t=articleResults\" target=\"_parent\">published simultaneously in the\u00a0<\/a><em><a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1200225?query=featured_home#t=articleResults\" target=\"_parent\">New England Journal of Medicine<\/a><\/em>,\u00a0\u00a0150 obese patients with uncontrolled type 2 diabetes were randomized to medical therapy alone or medical therapy plus either Roux-en-Y gastric bypass or sleeve gastrectomy.\u00a0Philip Schauer presented the main results.<\/p>\n<p>Percentages of patients with glycated hemoglobin level of 6% or less at 1 year:<\/p>\n<ul>\n<li>medical: 12%<\/li>\n<li>gastric bypass: 42%<\/li>\n<li>sleeve gastrectomy: 37%<\/li>\n<\/ul>\n<p>Mean glycated hemoglobin at 1 year:<\/p>\n<ul>\n<li>medical: 7.5<\/li>\n<li>gastric bypass: 6.4<\/li>\n<li>sleeve gastrectomy: 6.6<\/li>\n<\/ul>\n<p>Weight loss at 1 year:<\/p>\n<ul>\n<li>medical: -5.4 kg<\/li>\n<li>gastric bypass: -29.4 kg<\/li>\n<li>sleeve gastrectomy -25.1 kg<\/li>\n<\/ul>\n<p>Patients in the medical-therapy group increased their use of diabetes medications, whereas the surgical patients significantly dropped their use of these drugs. Some 38% of medical-therapy patients used insulin compared with only 4% and 8% in the gastric-bypass and sleeve-gastrectomy groups, respectively.<\/p>\n<p>The authors concluded that \u201cbariatric surgery represents a potentially useful strategy for management of uncontrolled diabetes, since it has been shown to eliminate the need for diabetes medications in some patients and to markedly reduce the need for drug treatment in others.\u201d<\/p>\n<p>In a second study, also\u00a0<a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1200111?query=featured_home\" target=\"_parent\">published in the\u00a0<em>New England Journal of Medicine<\/em><\/a>, bariatric surgery was also found to be highly effective for diabetic subjects. Sixty obese patients with diabetes were randomized to bariatric surgery (Roux-en-Y gastric bypass or biliopancreatic diversion) or conventional medical therapy.<\/p>\n<p>Diabetes remission at 2 years:<\/p>\n<ul>\n<li>medical therapy: 0%<\/li>\n<li>gastric bypass: 75%<\/li>\n<li>biliopancreatic diversion: 95%<\/li>\n<\/ul>\n<p>In their editorial, \u00a0Zimmet and Alberti wrote that one important implication of the studies is that bariatric surgery should perhaps \u201cnot be seen as a last resort.\u201d For some obese patients with diabetes, surgery \u201cmight well be considered earlier in the treatment.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Two new randomized trials offer evidence that bariatric surgery is highly effective in obese patients with diabetes. The results, according to Paul Zimmet and K. George M.M. Alberti, writing in\u00a0an editorial in the\u00a0New England Journal of Medicine, \u201care likely to have a major effect on future diabetes treatment.\u201d In the STAMPEDE trial, which was presented [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,7],"tags":[737,200,284,355],"class_list":["post-27708","post","type-post","status-publish","format-standard","hentry","category-general","category-prevention","tag-bariatric-surgery","tag-diabetes","tag-obesity","tag-weight-loss"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/27708","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=27708"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/27708\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=27708"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=27708"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=27708"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}