Bariatric surgery helps prevent type 2 diabetes

The New York Times “Well” blog reports, “For people who are extremely overweight and likely to develop diabetes, surgery may be the best form of prevention.”

A study published in the New England Journal of Medicine found that “weight-loss surgery not only produced sustained weight loss in obese men and women, but substantially reduced their odds of developing Type 2 diabetes.”

The AP reports that Swedish researchers followed “1,658 patients who had bariatric surgery – mostly bands and stomach stapling – and 1,771 similar patients who just got usual care and counseling on how to lose weight.”

None of the participants had type 2 diabetes at the start of the study. After about a decade “on average among those still in the study, 392 developed diabetes in the usual care group versus 110 in the surgery group.” In other words, surgery appeared to reduce the odds of developing type 2 diabetes by about 78%.

HealthDay reports that study lead author Lars Sjostrom, MD, PhD, of Gothenburg University, Sweden, “said that people with high fasting blood sugar levels that are still considered non-diabetic might be the ones who could benefit most from bariatric surgery. However, Sjostrom said he would still recommend that people try diet, exercise and medications to prevent diabetes first,” even though he conceded that “it’s often difficult to sustain those changes.”

WebMD explains that “according to accepted NIH guidelines, weight loss surgery is appropriate only for people whose body mass index (BMI) is 40 or higher, or 35 or higher for those with a serious obesity-related condition such as diabetes or heart disease.”

However, “Sjostrom and colleagues found that weight loss surgery prevented diabetes regardless of a patient’s BMI at the time of surgery.”

According to MedPage Today, an editorial accompanying the study called “the long-term findings from the Swedish Obese Subjects (SOS) study…both provocative and exciting – especially the findings that suggest that bariatric surgery may prevent the conversion of abnormalities in glucose metabolism to frank diabetes.”

The editorial “emphasized that more research is needed to determine which obese patients are most likely to benefit from bariatric surgery” and also “pointed out that surgery did not prevent diabetes in all patients, underscoring the multifactorial nature of obesity.”

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