Can Bariatric Surgery Work for Obese Diabetics Patients?

Posted by on Jun 12, 2012 in News | 0 comments

In the last few years, there are some surgeons who have been advocating bariatric surgery for obese diabetics. The premise behind this idea is that obese diabetics who lose weight may be better able to control their diabetes and also avoid the long term complications of obesity.

There are many anecdotal reports about the effectiveness of bariatric surgery for obese diabetics. Unfortunately many of these reports are published by individual surgeons or manufacturers of equipment needed for the surgery.

As far as clinical trials regarding bariatric surgery in diabetics is concerned, there are not many randomized clinical trials. However, one recent study of note looked at 150 obese diabetic patients who underwent surgery and followed them for 12 months. Several types of surgical procedures were performed and compared to medical therapy.

The surgery resulted in no deaths. The most significant observations were that obese diabetic patients who underwent surgery had a drastic decrease in their diabetic medications; better control of blood glucose and the weight loss was significant. Serious complications were more common in obese diabetics who underwent gastric bypass.

This is the first study, which reveals gratifying results in obese diabetics. Because the researchers only followed patients for 1 year, it is not known if the weight loss and other benefits are sustained.

So, should all obese diabetics undergo bariatric surgery?

No. On the negative side, bariatric surgery is not a cheap undertaking and is fraught with serious complications. For patients who are seriously thinking about bariatric surgery, the foremost thing is to find a decent surgeon. If for any reason, the surgeon does not explain the potential complications of the surgery, it is important to seek a second opinion. Some of the complications that occur after bariatric surgery are worse than diabetes itself.

Contributed by Dr. Steven Bhimji, M.D.
Source: Bariatric surgery versus intensive medical therapy in obese patients with diabetes.
N Engl J Med.  2012; 366(17):1567-76
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