Just published in the Lancet, a preeminent medical journal, a recent European study with more than 10 years of follow up compared surgical treatment of advanced type 2 diabetes to treatment with medications, diet, and lifestyle interventions.
The results show surgery is the clear winner, with patients randomized to the surgical arm experiencing fewer complications of diabetes, better kidney function, lowered cardiovascular risk, and better quality of life. Even though all patients began the trial with severe type 2 diabetes, one third of the surgical patients were considered “cured” of their type 2 diabetes based upon continuing to have normal blood sugars with no medication requirement a full 10 years after surgery.
This latest study from Italy and England confirms the findings of 12 previously published randomized prospective controlled trials which compare surgery against medical management of type 2 diabetes using shots, pills, and lifestyle interventions. All the studies show the superiority of surgery, which has become the far safer, lower-risk arm. At most centers, and in the hands of high-volume, experienced surgeons, metabolic surgical procedures are safer and as routine as an appendectomy, a gallbladder procedure, a hernia repair, or a C-section. But the benefits are long lasting, dramatically reducing the risks that type 2 diabetes poses, namely blindness, kidney failure, amputations, strokes, and heart attack.
The first author of the paper is Professor Giltrude Mingrone, professor of diabetes and nutrition at Kings College London, who stated to Science Daily, “These data corroborate the notion that surgery can be a cost-effective approach to treating type 2 diabetes. The evidence is now more than compelling that metabolic surgery should be considered as a main therapeutic option for the treatment of patients with severe type 2 diabetes and obesity.”
Mingrone, G., Panunzi, S., De Gaetano, A., Guidone, C., Iaconelli, A., Capristo, E., Chamseddine, G., Bornstein, S.R. and Rubino, F., 2021. Metabolic surgery versus conventional medical therapy in patients with type 2 diabetes: 10-year follow-up of an open-label, single-centre, randomised controlled trial. The Lancet, 397(10271), pp.293-304.
Kent C. Sasse, M.D., MPH, FACS, FASCRS, FASMBS Adjunct Assistant Professor, University of Nevada School of Medicine