Long-Term Benefits of Bariatric Surgery for Type 2 Diabetes Revealed in NIH-Supported Study
A groundbreaking study supported by the National Institutes of Health (NIH) has revealed the long-term benefits of bariatric surgery for individuals with type 2 diabetes. The study, published in JAMA and funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), compared the outcomes of bariatric surgery to medical management and lifestyle interventions. The results showed that those who underwent bariatric surgery achieved better long-term blood glucose control, had higher rates of diabetes remission, and were more likely to stop needing diabetes medications.
The study, a follow-up that combined data from four independent single-center randomized trials conducted in the United States, evaluated the effectiveness of bariatric surgery compared to intensive lifestyle and medication therapy. The original trials were conducted between May 2007 and August 2013 and involved adults with type 2 diabetes and overweight or obesity. The participants were randomized to either undergo bariatric surgery or receive medical management and lifestyle interventions.
Dr. Jean Lawrence, NIDDK project scientist, explained that bariatric surgery results in greater weight loss, which affects a person’s metabolic hormones and improves the body’s response to insulin and ability to maintain healthy blood glucose levels. The study’s findings demonstrate that individuals with overweight or obesity and type 2 diabetes can make long-term improvements in their health and change the trajectory of their diabetes through surgery.
The study included a total of 262 participants from the four original trials. Of these, 166 underwent bariatric surgery, while the remaining 96 received medical/lifestyle management. At seven years, the surgery group experienced an average weight loss of 20%, compared to 8% in the medical/lifestyle group. The surgery group also had greater improvements in blood glucose control, with 54% achieving an HbA1c less than 7%, compared to only 27% in the medical/lifestyle group. Additionally, more participants in the surgery group achieved diabetes remission, and the percentage of participants using medications to treat diabetes decreased from 98% to 61%.
Importantly, the study also showed that bariatric surgery had significant benefits for individuals with a BMI between 27 and 34, which falls within the overweight and lower obesity ranges. This finding provides valuable information about the benefits of surgery for individuals who do not meet the traditional BMI threshold of 35 for bariatric surgery.
While no differences in major adverse events were observed between the two groups, the surgery group did experience a higher number of fractures, anemia, low iron, and gastrointestinal events. These issues may be attributed to nutritional deficiencies, highlighting the importance of continued monitoring for individuals who undergo bariatric surgery.
Dr. Griffin P. Rodgers, NIDDK Director, emphasized the significance of the study in advancing clinical knowledge and improving long-term health outcomes for individuals with obesity and type 2 diabetes. He stated that public investments in obesity and diabetes research can lead to real clinical advances and benefit millions of Americans.
The study, known as the Alliance of Randomized Trials of Medicine vs. Metabolic Surgery in Type 2 Diabetes (ARMMS-T2D), was supported by cooperative agreement U01DK114156 from NIDDK.
In conclusion, this NIH-supported study provides compelling evidence for the long-term benefits of bariatric surgery in individuals with type 2 diabetes. The results demonstrate that bariatric surgery leads to greater weight loss, improved blood glucose control, and higher rates of diabetes remission compared to medical management and lifestyle interventions. These findings offer hope for individuals with type 2 diabetes and overweight or obesity, showing that surgery can have a transformative impact on their health and diabetes management. Continued research and monitoring are necessary to ensure the safety and effectiveness of bariatric surgery in the long term.
