Bariatric surgery would be more effective than usual treatment to prevent type 2 diabetes in obese patients, according to the study.
Bariatric surgery would be “much more effective than usual treatment” to prevent type 2 diabetes in obese patients, according to a team from Sweden in the New England Journal of Medicine .
In a case-control study, surgery reduced the risk of developing the disease in the long term by 78 percent.
In the 1,658 patients operated, mainly with vertical band gastroplasty, the risk of developing diabetes was 0.68 percent per year. In contrast, among the 1,771 patients treated traditionally, the risk quadrupled (2.84 percent per year).
“Most of the published studies on bariatric surgery focused on the remission of diabetes. This study is about prevention, ”said Dr. Ted Adams of the University of Utah, who was not involved in the study.
“We detected a marked delay (in the onset of diabetes) in 15 years,” said Dr. Lars Sjostrom of the Swedish University of Gothenburg and co-author of the report. “Some patients will develop diabetes later. But, in perspective, the difference is huge. ”
In addition, the improvement arose although the operated patients already had a higher risk of developing diabetes than the control group.
The team also found that the initial body mass index was not associated with the risk of type 2 diabetes. Initial blood glucose levels were more effective. Something similar had been determined in studies on the effect of surgery on the frequency of heart attacks, strokes, cancer prevention and overall mortality.
Therefore, the author said that “it is time to pay less attention to the degree of obesity when patients are selected to use bariatric surgery.”
In an editorial, Dr. Danny Jacobs of the Duke University School of Medicine in North Carolina writes: “Taking into account the results of bariatric surgery in millions of obese adult candidates remains impractical and unjustified.” . But he admitted that the results would help doctors understand why different types of surgeries work and select the best candidates for those procedures.
For Sjostrom, more studies are needed and the analysis of the cost of benefits and the complications of the operation being carried out will be published within a year or more.
The authors remember that changing the lifestyle or using drugs to lose weight reduces the risk of developing diabetes by 40-45 percent. To determine if weight loss surgery would have the same effect, the authors designed the new study, which depends on a larger one called Sweden’s Obese People (SOS). No patient had diabetes at the start of the SOS study in 1987. Admission closed in February 2001.
The operated group had lost 20 kg at 10 and 15 years after the intervention, while the control group weighed about 3 kg less than at the beginning of the study. This group had only received preventive care with recommendations to eat better and exercise more.
The team estimated that surgery reduces the risk of developing diabetes by 83 percent. In 2009, the SOS team had shown that bariatric surgery reduces the risk of cancer in obese women and in 2007 had found that it reduces long-term mortality.