Bariatric Surgery for Diabetes Selected as Top Medical Innovation

A multitude of recent studies have demonstrated the effectiveness of bariatric surgery in improving type 2 diabetes; now Cleveland Clinic physicians and researchers have selected bariatric surgery for diabetes as the top medical innovation of 2013. Type 2 diabetes makes up most of diabetes cases. It most often occurs in adulthood, but teens and young adults are now being diagnosed with it because of high obesity rates. As of 2010, 25.8 million Americans had type 2 diabetes, according to the Centers for Disease Control & Prevention (CDC), and as much as 85 percent of people with the condition are overweight or obese. The combination of obesity and diabetes is particularly troublesome because it significantly  increases the risk of heart attack, stroke, and other major medical problems.

An anti-diabetic effect of bariatric surgery was first noted as an unexpected side benefit of the procedures. The effect has been demonstrated using a variety of surgical approaches, including Lap-Band, gastric bypass, and sleeve gastrectomy. The metabolic effects of the surgeries can be so profound that these procedures are sometimes referred to now as “metabolic” surgeries as opposed to simply “bariatric” or “weight loss” surgeries. Earlier this year, 2 studies were published in the prestigious New England Journal of Medicine (NEJM) showing that weight loss surgery is more effective at improving or resolving diabetes in obese patients than other treatments, including diabetes medications and lifestyle modifications. In a recent Cleveland Clinic trial, after one year, patients who underwent gastric bypass or sleeve gastrectomy lost more weight and were significantly more successful at controlling their diabetes, compared to those who simply took medications. Even more recently, a study also published in NEJM found that bariatric surgery may actually prevent the onset of type 2 diabetes. It was the first large study to show a long-term preventive effect of surgery in people who were not yet diabetic, but on their way. Several other studies on bariatric surgery and diabetes are on-going, and their combined efforts could soon expand the criteria for weight loss surgery.

In the Cleveland Clinic poll, leaders in medicine were asked to choose the top medical innovations from a list of 150 nominations of emerging technologies judged to have the ability to help the most people. They selected weight loss surgery for diabetes as the top innovation. Also ranked highly in the poll were: Neuromodulator device therapy for cluster and migraine headaches, mass spectrometry for clinical bacterial identification, new drugs therapies for prostate cancer, handheld optical scans for melanoma and femtosecond laser cataract surgery.

Dr Jaime Ponce, President of the American Society for Metabolic & Bariatric Surgery, spoke to us about this innovation: “As the obesity rates continue to increase, Type 2 Diabetes has become more prevalent, which has given rise to the name “diabesity” problem. Plenty of evidence is available demonstrating that weight reduction and decrease caloric intake is crucial in improving type 2 diabetes in obese patients. For some patients, the most reliable solution is metabolic surgery, which has been proven to be the most effective treatment in several randomized clinical studies. All procedures including the gastric banding, sleeve gastrectomy, gastric bypass and biliopancreatic diversion have shown to be more effective than medical treatment and offer a more stronger and durable effect. As Cleveland Clinic leaders have decided, certainly metabolic and diabetes surgery deserves to be the top medical innovation.”

Related Reading: Gastric Bypass for Mildly Obese People with Diabetes

by Emma Squillace

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