WASHINGTON – New research is boosting hopes weight-loss surgery can put some patients’ diabetes into remission for years and perhaps, in some cases, for good.
Doctors have presented longer results from a landmark study showing stomach-reducing operations are better than medications for treating “diabesity,” the deadly duo of obesity and Type 2 diabetes. Millions of Americans have this and can’t make enough insulin or use what they do make to process food.
Many experts were skeptical the benefits seen after a year would last.
Now, three-year results show an even greater advantage for surgery:
Blood-sugar levels were normal in 38 percent and 25 percent of two groups given surgery – but in only 5 percent of those treated with medications.
The results are “quite remarkable” and could revolutionize care, said one independent expert, Dr. Robert Siegel, a cardiologist at Cedars-Sinai Medical Center in Los Angeles.
“No one dreamed, at least I didn’t,” obesity surgery could have such broad effects long before it caused patients to lose weight, he said. Some patients were able to stop using insulin a few days after surgery.
At three years, “more than 90 percent of the surgical patients required no insulin,” and nearly half had needed it at the start of the study, said its leader, Dr. Philip Schauer of the Cleveland Clinic. In contrast, insulin use rose in the medication group, from 52 percent at the start to 55 percent at three years.
The results were reported last week at an American College of Cardiology conference in Washington. They also were published online by the New England Journal of Medicine.
Doctors are reluctant to call surgery a possible cure because they can’t guarantee diabetes won’t come back.
About 26 million Americans have diabetes, and two-thirds of them are overweight or obese. Diabetes is a leading cause of heart disease, strokes, kidney failure, eye trouble and other problems.
It’s treated with various drugs and insulin, and doctors urge weight loss and exercise, but few people can drop enough pounds to make a difference. Bariatric surgery currently is mostly a last resort for very obese people who have failed less drastic ways to lose weight.
It costs $15,000 to $25,000, and Medicare covers it for very obese people with diabetes.
An obesity-surgery equipment company sponsored the study, and some of the researchers are paid consultants; the federal government also gave grant support.
Dr. Robert Ratner, chief scientific and medical officer for the American Diabetes Association, said he was “very encouraged” so many stayed in the study and said it will remain important to follow participants longer because many people who have weight-loss surgery regain substantial weight down the road.
Diets cost less and have fewer side effects, he said.
On the Net
Surgery explainer: http://1.usa.gov/1gHoOX4
Weight loss information: http://1.usa.gov/1gTBk6Q
Diabetes information: www.diabetes.org
