In a new study, researchers found that metabolic surgery is more effective than drugs and lifestyle interventions in the long-term control of severe type 2 diabetes.
They also found that over one-third of surgically-treated patients remained diabetes-free during the 10-year period of the trial.
This demonstrates, in the context of the most rigorous clinical definition, that a “cure” for type 2 diabetes can be achieved.
The study was conducted by a team from King’s College London and elsewhere.
The team tested 60 patients with advanced type 2 diabetes and were treated at a major academic hospital in Rome, Italy.
The patients randomly underwent drugs plus lifestyle interventions or metabolic surgery (gastric bypass or biliopancreatic diversion).
At the start of the study, all patients had severe disease, with poorly controlled blood sugar levels and more than five years history of diabetes.
The team found that 37.5% of surgically treated patients were able to maintain non-diabetic glycemia without the need for diabetes medication—a condition referred to as diabetes remission—for the duration of the 10-year study period.
In 2009, American Diabetes Association defined “cure” of diabetes as a continued state of disease remission for more than 5 years.
The findings provide the most robust scientific evidence yet that full-blown type 2 diabetes is a curable disease, not inevitably progressive and irreversible.
In addition to represent a major advance in the treatment of diabetes, metabolic surgery is the best lead to the elusive cause of the disease
Compared to conventional medical treatment, surgery also resulted in better overall metabolic control, lower heart disease risk, better kidney function and quality of life.
Notably, patients treated surgically had a much lower incidence of diabetes-related complications, including cardiac, renal, and neurological adverse events.
Metabolic surgery also reduced medication usage, including drugs for diabetes, high blood pressure and dyslipidemia.
Previous studies had shown that bariatric or weight loss surgery can induce long-term remission of diabetes in patients with very severe obesity; however, most patients who undergo traditional weight loss surgery have typically mild or recent-onset diabetes.
This study shows the potential curative effect of metabolic surgery for patients with severe disease.
One author of the study is Professor Francesco Rubino.
The study is published in The Lancet.
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