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Are Weigh-loss Surgery More Effective Than Drugs To Treat Type-2 Diabetics? More than 380 million people worldwide are affected by diabetes. The World Health Organization (WHO) estimates that by 2030, the number of people living with diabetes will more than double. If not managed properly, diabetes can lead to a number of long-term complications, including heart disease, strokes, blindness, kidney failure, nerve damage, impotence in men and blood vessel disease that may require an amputation. Diabetes is a disease in which the body is unable to properly use and store glucose, causing the body’s blood glucose level to rise too high. There are 2 common types of diabetes: Type-1 and Type-2. In Type-1 diabetes, the body completely stops producing any insulin, while in Type-2 diabetes, the body does not produce sufficient or is unable to use insulin properly (insulin resistance). Only 5 percent of diabetic patients belong to Type-1 whereas Type-2 accounts for about 90 to 95 percent of diabetes cases. Type-1 diabetes is usually diagnosed in children and young adults while Type-2 diabetes is usually found in people who are over 40, overweight or obese, and have a family history of diabetes. Management of the condition usually requires taking medications or insulin on time, together with lifestyle changes like regular physical exercise and healthy diet. But for diabetics who are obese, these measures alone are barely enough. Studies have shown that weight-loss surgery is more effective than conventional treatment for the short-term control of Type-2 diabetes, though these studies were characterized by a relatively short follow-up.
Various types of weight-loss surgery are available. Some help one lose weight by shrinking the size of the stomach so he or she feels full after small meals, some changes the way the body absorbs calories, nutrients, and vitamins, and others do both. A study that was published online September 3, 2015 in ‘The Lancet’ revealed that weight-loss surgery beats medication for controlling Type-2 diabetes in obese patients. Half of the patients treated with weight-loss surgery were diabetes-free at 5 years, according to the researchers from Kings College London. In 2009, 60 patients aged between 30 and 60 years with a body-mass index (BMI) of 35 or more and a history of Type 2 diabetes lasting at least 5 years were selected. Among these patients, 20 were randomly assigned to receive medical treatment, 20 to receive a type of weight-loss surgery called gastric bypass, and 20 to undergo a weight-loss operation called a biliopancreatic diversion. 80 percent of patients who had surgery had their blood sugar under good long-term control, compared to about 25 percent of the patients treated with medications only. While all of the study groups had a reduction in cardiovascular risk, the surgery-treated patients had a 50 percent lower risk of heart and blood vessel disease than those treated with medications only, and they also required fewer drugs for treating high blood pressure or high cholesterol. The improvements in blood sugar control and heart disease risk were, however, not related to how much weight patients lost. The exact reason for the remission of diabetes in the study remains mysterious. But the researchers explained that the intestines produce a host of hormones involved in regulating metabolism. Reconstructing the gastrointestinal tract so that food bypasses the stomach and small intestine may help restore normal metabolic control. Based on the new findings, some doctors suggest that bariatric surgery should be offered to these patients if they are moderately obese, for instance, with a BMI of 35. The National Institutes of Health currently states that patients should have a BMI of 40, or a BMI of 35 with obesity-related illness like Type-2 diabetes, in order to be eligible for weight-loss surgery. Nevertheless, one should note that weight-loss operations do carry risks, just like any other surgery, and some patients who had the surgery may gain back some of the weight they lost.
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