A new study shows that for adults with type 2 diabetes, surgery is more effective than medication and lifestyle changes for reducing blood sugar levels and losing weight—no matter where someone lives or their financial situation. The research was published on January 20 in the Annals of Internal Medicine.
Type 2 diabetes (T2D) is a long-term condition where the body cannot properly use or produce insulin, a hormone that helps control blood sugar. Many people with T2D also struggle with being overweight or obese, which can make the disease harder to manage.
Traditionally, treatment includes medication and changes in diet and exercise. In recent years, metabolic bariatric surgery—commonly known as weight-loss surgery—has become another option, especially for people who find it difficult to control their diabetes through medication alone.
The new study was led by Dr. Mary Elizabeth Patti from Joslin Diabetes Center and Harvard Medical School. She and her team wanted to see whether surgery worked better than medication in people from different backgrounds, including those who live in areas with fewer resources and more challenges—something scientists call “social vulnerability.”
To measure this, they used a tool called the Area Deprivation Index (ADI), which ranks neighborhoods based on things like income, education, and housing. People in high ADI areas tend to face more difficulties accessing health care and maintaining healthy lifestyles.
The researchers looked at data from 258 adults with type 2 diabetes who were taking part in four randomized clinical trials at U.S. medical centers. In each trial, people were randomly assigned to either have surgery or receive standard medical treatment and lifestyle support. Some participants lived in high ADI areas and others in low ADI areas.
The results were clear: Surgery led to better outcomes than medication, both for people in high-ADI and low-ADI areas. People who had surgery lowered their hemoglobin A1c (HbA1c)—a key blood marker used to track blood sugar over time—by about 1% more than those who used only medical therapy.
Surgery also led to greater weight loss: about 10% to 13% more weight lost, depending on the participant’s ADI level.
Importantly, the study found that social vulnerability didn’t change how effective the surgery was. Whether someone came from a low-resource area or a wealthier neighborhood, surgery still had a strong impact.
However, the researchers did notice that people who received only medical treatment showed more variation in their results based on their social background. This suggests that people from more disadvantaged areas might struggle more with sticking to long-term medication and lifestyle plans.
The study highlights an important message: Surgery could be a powerful tool for managing diabetes and weight problems across all social groups. It also shows that people in harder life situations might especially benefit from treatments that don’t require constant self-management, like surgery.
The authors also noted that several of the researchers had ties to the biopharmaceutical industry, which is common in medical research and disclosed as part of ethical reporting.
Overall, this study supports the growing use of metabolic surgery for people with type 2 diabetes and suggests it can work well regardless of where someone lives or how much money they have.
If you care about diabetes, please read studies about bananas and diabetes, and honey could help control blood sugar.
For more health information, please see recent studies about Vitamin D that may reduce dangerous complications in diabetes and results showing plant-based protein foods may help reverse type 2 diabetes.
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