Bariatric surgery could be a potentially effective “tool” for treating type 2 diabetes. A new study found that after three years of bariatric surgery, patients with type 2 diabetes returned to normal blood sugar levels and no longer needed diabetes medications such as insulin.
Researchers at the nation’s top Cleveland Clinic conducted a three-year trial called Surgery and Medication for the Elimination of Diabetes (STAMPEDE).
STAMPEDE was a three-group randomized controlled single-center trial (medication, gastric bypass surgery, and sleeve gastric reduction groups) that included 150 obese patients with at least eight years of type 2 diabetes that was not well controlled. The trial was randomized using zone groups to assign patients 1:1:1 according to the baseline of insulin use. Selection criteria were age 20-60 years, glycosylated hemoglobin HbA1c level >7.0% and body mass index (BMI) value 27-43 kg/m2. all patients were already taking at least 3 diabetes medications and at least 3 cardiac medications.
The results showed that after three years, 38% of patients in the gastric bypass bariatric surgery group and 24% of patients in the sleeve gastrectomy group had reduced their HbA1c levels to 6% and below, and most (>90%) of the patients who underwent surgery no longer required oral diabetes medications or insulin for glycemic control. In contrast, only 5% of patients in the medication group had reduced their blood glucose levels to 6% or less, and 55% of patients still required insulin. (The American Diabetes Association recommends glycosylated hemoglobin control at less than 7%, the International Diabetes Federation recommends glycosylated hemoglobin control at less than 6.5%, and China has set the glycosylated hemoglobin control standard for diabetics at less than 6.5%.)
“Exciting! We initially thought diabetes was irreversible or incurable. We are now realizing that some diabetics are curable.” Sangeeta Kashyap, one of the leaders of the study, said.