Bariatric Surgery Provides Long-Term Control of Diabetes, Cleveland Clinic Study Reports

Researchers at the Cleveland Clinic found that an effective and durable treatment for Type II Diabetes in obese patients is in fact, bariatric surgery. Their study found that the surgical procedure helped surgical patients to be insulin free and to be free of many diabetic medications nearly three years after surgery.

The trial, STAMPEDE (Surgical Therapy and Medications Potentially Eradicate Diabetes Efficiently) was recently published in the New England Journal of Medicine as well as presented at the Annual Scientific Session of the American College of Cardiology in Washington, D.C. on April 1, 2014.

An estimated one in three adults in the United State is obese; obesity is the main trigger for Type II Diabetes. According to the American Diabetes Association, as much as 1 in 3 American adults will be diagnosed with Diabetes by the year 2050.

About the Study

The study also found that weight loss surgery patients also experienced an improvement in their quality of life as well as a reduction in cardiovascular medications that were used to control cholesterol and blood pressure compared to those receiving medical therapy. As a result of these positive changes, these patients in the surgery groups used less glucose-lowering medications as well as cardiovascular ones. Also, 5-10% was on insulin compared to 55% of the patients just in the medical therapy group.

The STAMPEDE study is the largest random trial with one of the longest follow-up times comparing bariatric surgery with medical therapy. The trial followed 150 overweight patients with poorly-controlled diabetes. These patients were divided in three different groups – 50 patients receiving only medical therapy, 50 patients who had Roux-en-Y gastric bypass surgery and received medical therapy and 50 patients who had a sleeve gastrectomy and also received medical therapy.

The effectiveness of the surgery was gauged by the percentage of patients that achieved control of their blood sugar (defined as hemoglobin HbA1c level of less than or equal to 6%). This is a standard lab test that studied average blood sugar for a three-month period.
At the three-year mark, 37.5% of the gastric bypass group achieved full blood sugar control without using any diabetes medications compared to the other two groups. Just 5% of the medical therapy and 24.5% of the sleeve gastrectomy group achieved the same result.

The study’s researchers were able to evaluate the impact of diabetes and obesity on a patient’s quality of life after three years.
Ultimately, there was really no significant improvement in the medical therapy group and the sleeve gastrectomy group saw great results, but not as much as the gastric bypass surgery patients.