A 7-year follow-up study in the United Kingdom has shown that weight loss surgery reduces the risk of developing type 2 diabetes by 80 percent compared to conventional treatment.
The study is the first to examine the role of existing weight-loss surgery methods in the prevention of type 2 diabetes in the real world. Researchers Helen Booth of King’s College London, Omar Khan of the Whittington Hospital and colleagues enrolled 2167 patients who underwent bariatric surgery and 2167 controls matched for age, sex and BMI from the UK primary care database. Of these, 49%, 37%, and 15% of patients in the bariatric surgery group underwent laparoscopic gastric banding, gastric bypass, and gastrectomy, respectively. After a median follow-up of 2 or 8 years, fewer patients in the bariatric surgery group had diabetes (4 or 3% vs. 16 or 2%) and a lower incidence of diabetes (5 or 7/1000 person-years vs. 28 or 2/1000 person-years). After correcting for baseline characteristics such as age, BMI, gender and HbA1c, weight loss surgery reduced the risk of developing diabetes by 80% compared to conventional treatment.
The researchers emphasize that obesity is currently underappreciated by many people, with only 1% of those who could benefit from bariatric surgery in the UK undergoing it, and many obese patients are often not referred for bariatric surgery until after they develop diabetes and its complications. The study suggests that interventions for obese people should be carried out before they develop diabetes, as this is better and more cost-effective for patients.
Jacques MHimpens of the University Hospital of StPierre, France, commented that the results of the study are important and provide further evidence that bariatric surgery affects the incidence of new-onset type 2 diabetes. There is an urgent need for more evidence to inform endocrinologists about the benefits of weight loss surgery.
The investigators responded that it is likely that some patients without diabetes who undergo bariatric surgery will still develop diabetes over time. However, more of those who did not have bariatric surgery certainly gained weight than those who had bariatric surgery. The difference between the two may be greater over time. Even if this is the case, weight loss surgery at least has the effect of delaying the onset of diabetes and is still beneficial to patients. It is well known that obesity prevention is a long-term process and that weight loss surgery is a very good short-term solution. In the short and medium term, bariatric surgery is beneficial in the prevention and treatment of diabetes.