One of the ongoing debates in type 2 diabetes treatment, specifically in obese and morbidly obese patients, is weighing lifestyle intervention versus bariatric surgery. Past smaller studies have shown the excellent short-term benefits of bariatric surgery on obese and morbidly obese patients with type 2 diabetes including better glycemic control and reduction and/or discontinuation of all medications. However, the medical community has requested longer term studies to decide if bariatric surgery can be used as a first line treatment for such patients.

While it still remains to be seen if the benefits of bariatric surgery can result in life-long remissions, a recent study did show that patients can experience positive results up to three years after surgery (post-op).

Researchers from the University of Pittsburgh Medical Center assessed patients outcomes for 3 years. Sixty-one obese participants with type 2 were randomly assigned to either an intensive lifestyle weight loss intervention for 1 year followed by a low-level lifestyle intervention for 2 years, or surgical treatments (Roux-en-Y gastric bypass [RYGB] or laparoscopic adjustable gastric banding [LAGB]) followed by a low-level lifestyle intervention in years 2 and 3.

Results showed diabetes medications were reduced more in the surgical groups than the lifestyle intervention-alone group: 65 percent of RYGB, 33 percent of LAGB, and none (0%) of the intensive lifestyle weight loss intervention participants went from using insulin or oral medication at baseline to no medication at year 3. Average reductions in percentage of body weight at 3 years were the greatest after RYGB at 25 percent, followed by LAGB at 15 percent, and lifestyle treatment at 5.7 percent.

“Those who underwent a surgical procedure followed by low-level lifestyle intervention were significantly more likely to achieve and maintain glycemic control than were those who received intensive and then maintenance (low-level) lifestyle therapy alone, regardless of obesity class. More than two-thirds of those in the Roux-en-Y gastric bypass (RYGB) group and nearly half of the LAGB group did not require any medications for T2DM treatment after three years,” the study’s authors stated.

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Source: The JAMA Network Journals