Friday, September 11, 2015

Weight Loss Surgery Could Cure 50% of Type-2 Diabetes

Weightloss Surgery Could Cure 50% of Type-2 Diabetes

According to a new study published in The Lancet, weight loss surgery could put half of patients with type-2 diabetes in remission for at least five years. The trial of 60 patients - of which 53 continued to the end - was carried out by an international team from King's College London and the Università Cattolica in Rome. The surgery was able to improve symptoms both through weight loss and by changing the way the gut functions. Back in 2009, the team randomly assigned the 60 patients to receive one of three treatments. One group would receive a type of weight loss surgery called a gastric bypass, and another would have another type of operation known as a biliopancreatic diversion. The final group would continue on with their regular medicinal treatment and wouldn't receive any surgery. Professor Francesco Rubino is one of the authors of the study and the surgeon who operated on the patients. He explained that half of the patients who were operated on had their blood levels return to non-diabetic levels for about five years. On top of this, a whopping 80% of the operated-on participants were able to achieve "optimal control" of their blood sugar levels, despite only receiving one or none of their medication at all. Patients who received surgery were also found to have a better quality of life and were less likely to develop heart problems, which is a common side effect of uncontrolled diabetes. Interestingly, none of the study participants who were only receiving their medication achieved remission status. Professor Rubino explained that treating patients with surgery rather than medical therapy could be more cost-effective in the long term because there is less use of medication, which can be expensive. "The ability of surgery to greatly reduce the need for insulin and other drugs suggests that surgical therapy is a cost-effective approach to treating type-2 diabetes," he said. The results seem to peak about two years after surgery, as some of the patients relapsed after this time - but not all of them. This means that there needs to be continued monitoring of blood sugar levels, even after the operation. Professor Rubino added that while it isn't known why the surgery caused diabetes to go into remission, it could be something to do with the intestines being exposed to less food. The intestines are known to produce a host of hormones involved in regulating metabolism. Because of this, the surgeons theorise that by reconstructing the gastrointestinal tract (so that food bypasses the stomach and small intestine), normal metabolic control is restored. Also writing in The Lancet, Dr Carel le Roux and Dr Dimitri Pournaras described diabetes as "becoming the plague of the 21st century", but that the results of this study were remarkable. "Surgery for diabetes seems to be safe, effective in terms of glycaemic control, and is now associated with reduced complications of diabetes," they said. Dr le Roux and Dr Pournaras pointed out that this potentially life-saving option needs to become more available as it is only offered to a few patients at the moment. They also hope for more trials in the future: "The ultimate question is whether diabetes surgery is associated with reduced mortality." And as soon as we know the answer to that, we'll update you.

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