Bariatric Surgery Helps Control Diabetes for Years

You may remember that “bariatric surgery for diabetes” was named the 2013 top medical innovation by Cleveland Clinic. Now, even more evidence points to the benefits. Encouraging new findings show that bariatric surgery is effective at controlling type 2 diabetes long after surgery.  The landmark STAMPEDE trial (Surgical Treatment And Medications Potentially Eradicate Diabetes Efficiently) is the largest randomized trial of its type and one of the longest that compares medical therapy to bariatric surgery. The STAMPEDE trial now has 3 years of data to evaluate.

STAMPEDE included 150 obese patients with type 2 diabetes. All of the patients were taking medicine to control their condition. Fifty patients underwent sleeve gastrectomy surgery, 50 underwent gastric bypass surgery, and 50 did not have sugery. Instead they took medicine and received intensive counseling.

The key findings at 3 years included:

• Thirty-five percent of patients who had surgery achieved a 3 year remission of diabetes or much improved blood sugar control.
• None of the medicine-only patients achieved remission and their improvement in blood sugar was much less than the patients who had bariatric surgery.
• As much as 90% of the patients who had bariatric surgery no longer needed to take insulin, while only about 45% of the patients in the non-surgery group were able to discontinue insulin.
• Surgery patients needed less medicine to control their blood pressure and cholesterol.
• Patients who received surgery reported significant improvements in quality of life, while the medication-only group reported no improvement.

As a whole, the research shows that bariatric surgery is more effective–with persistent benefits up to three years shows in this trial–in treating diabetes in moderate and severely obese patients, as compared to standard medical therapy.  “This article is another landmark study in the evolution of diabetes treatment,” said Dr. Daniel Cottam, bariatric surgeon in  Salt Lake City.  “We now are entering a phase of medicine where we no longer question if surgery is better for diabetic patients, but which surgery is better for diabetic patients.  This presents new horizons where surgery will be seen as first line treatment for type 2 diabetes, hypertension and cholesterol problems.”

The study adds to earlier research showing the positive effects of surgery in patients with diabetes. You can read about two important, related studies published in 2012 here.