Study Associates Weight-Loss Surgery with Diabetes Remission

A long-term study of type 2 diabetes patients who had weight-loss surgery showed that they were associated with more frequent diabetes remission and fewer complications as compared to patients who received standard care for the disease.

The study was conducted by Lars Sjostrom, M.D., Ph.D., University of Gothenburg, Sweden, and is based on the data from the Swedish Obese Subjects (SOS) study, which was conducted at 25 surgical departments and 480 primary health care centers in Sweden.

SOS is an ongoing prospective, matched, surgical intervention study involving 4047 obese subjects and is designed to offer controlled prospective long-term conditions to investigate the effects of bariatric surgery and weight loss on mortality and other objective endpoints. Patients were recruited through matching examination between September 1, 1987 and January 31, 2001 (a 13.4 year recruitment period).

Rajeev Vohra, MD, FACS, director of minimally invasive and bariatric surgery at South Nassau Communities Hospital, said, “This study corroborates the findings of previous studies that weight-loss surgery can reverse and possibly cure diabetes as well as improve or eliminate health complications related to the disease.”

Of the patients enrolled in SOS between September 1987 and January 2001, 260 (of 2,037) standard care and 343 (of 2,010) weight-loss surgery patients were diagnosed with diabetes at SOS health examinations and information on their diabetes complications was obtained from national health registers. The median follow-up time for diabetes complications was 17.6 years in the patients who received standard care, and 18.1 years in the patients who had weight-loss surgery.

The proportion of patients in remission (defined as blood glucose <110 mg/dL and no diabetes medication) after 2 years was 72.3 percent in the surgery group and 16.4 percent in the group that received standard care. At 15 years, the diabetes remission rates decreased to 30.4 percent for weight-loss surgery patients and 6.5 percent for standard care patients. All types of bariatric surgery (adjustable or nonadjustable banding, vertical banded gastroplasty, or gastric bypass) were associated with higher diabetes remission rates compared with standard care.

“In this very long-term follow-up observational study of obese patients with type 2 diabetes, weight-loss surgery was associated with more frequent diabetes remission and fewer complications than usual care. These findings require confirmation in randomized trials,” Dr. Sjostrom concluded.

The study also associated weight-loss surgery with a decreased incidence of microvascular complications, which affect small blood vessels creating problems with the eyes, nerves, and kidneys and macrovascular complications which affect the larger blood vessels, taking their toll on the heart and brain.

Under the direction of Rajeev Vohra, MD, FACS, director of minimally invasive and bariatric surgery, South Nassau Communities Hospital’s Center for Weight and Life Management is one of the area’s most experienced at performing bariatric surgery. Overall, the Center for Weight and Life Management has successfully performed more than 4,000 weight loss surgeries, including gastric sleeve, gastric bypass, LAP-BAND, single-incision and revisional surgery, such as gastric banding over bypass. All of these surgeries are performed laparoscopically, which is less invasive and typically reduces the patient’s length of hospital stay.

Dr. Vohra is complemented by a weight loss team composed of highly trained surgeons, a program coordinator, patient liaison, physician assistant, registered dietitians and psychologist who are there to support the patient throughout his or her weight-loss journey. The team empowers patients to make significant changes in their lifestyle – especially in their eating habits.

South Nassau Communities Hospital is designated an Accredited Bariatric Surgery Center by the American Society for Metabolic and Bariatric Surgery (ASMBS). Accredited hospitals have demonstrated that they meet standards to perform safe bariatric surgery and have documented excellent short- and long-term patient outcomes. South Nassau is authorized to provide weight-loss surgery to all Medicare eligible patients. The Centers for Medicare and Medicaid Services’ (CMS) decision to expand coverage is based on the “demonstrated high success rates” achieved by hospitals that have been so accredited.