August 2, 2014
Bariatric Surgery: The Better Choice for Diabetes (15-year results)
Bariatric Surgery: The Better Choice for Diabetes
There have been a few short-term (5-years and less) studies documenting the real-life advantages of bariatric surgery over best medical therapy in the control and reversal of diabetes. One of the key points arising from these studies is the question on the longevity of surgery in keeping diabetes at bay.
Recently, this has been addressed but yet another update on bariatric surgery’s most illustrious research group, the Swedish Obese Subjects (SOS) study, which published data on their 15-year results. SOS is a prospective matched cohort study that recruited patients in Sweden from September 1987 to January 2001, with 260 of 2037 control patients and 343 of 2010 surgery patients with type 2 diabetes at baseline.
About 2 thirds of the surgical patients underwent the vertical banded gastroplasty, while the remaining had equal numbers of gastric bands and gastric bypasses.
The 2-year analysis of results showed that 72.3% of the surgery patients experienced remission from diabetes, having normal blood sugar levels without the need for diabetic medications. This is in comparison with 16.4% achieving the same results without surgery. These figures are comparative to those from later studies.
At the 15-year analysis, the rates of remission in the surgery group dropped to 30.4%, compared to 6.5% in the control group. Despite this expected decline in the rates of diabetic remission, it was found that the cumulative incidence of microvascular and macrovascular complications as a result of diabetes was significantly lower in those who had bariatric surgery. Examples of microvascular and macrovascular complications from diabetes include ischaemia heart disease (heart attacks), cerebrovascular accidents (strokes), diabetic nephropathy (kidney failure) and peripheral vascular disease (foot ulcers).
In summary, in simpler terms, this study reaffirms that bariatric surgery is indeed better than medical therapy in diabetic control in the short term (2 years). Even though the rates of control falter somewhat in the longer term (15 years), it remains superior to medical therapy. To top it up, presumably from having better control of sugar levels over the years, the incidence of complications of having diabetes is remarkably lower in those who have had bariatric surgery.
To find out more on bariatric surgery and how it can benefit your metabolic health, contact the Clinic for Digestive Surgery at +65 6570 2702 to speak to our Clinic Nurse. Alternatively, drop us an email at doctor@clinicfordigestivesurgery.com, or fill up the enquiry form at http://clinicfordigestivesurgery.com/contact. We will attend to you at the soonest opportunity.
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