Surgery better than drug therapy for type 2 diabetes

DIABETES DIGEST – June 28, 2014 – If you have type 2 diabetes associated with a weight problem, surgery may be more effective for controlling your diabetes, not to mention your weight, than taking medications. Of course there is always a catch, in this case the effect may not last. 

Researchers and endocrinologists, doctors who treat diabetes and other hormone related conditions, met in Chicago last week at the annual International Society of Endocrinology and the Endocrine Society: ICE/ENDO 2014. One of them, Dr. Pietra Greenberg at James J. Peters Veterans Affairs (VA) Medical Center in New York presented her study of medical records of 53 vets with type 2 diabetes. It is among only a few studies to compare surgery to drug therapy for managing type 2 diabetes.

Of the 53, 30 of them underwent sleeve gastrectomy, which is a minimally invasive surgery that involves small incisions and removal of a section of the stomach leaving the patient with a stomach about 25 percent of the original size. The other 23 continued taking medications to control their diabetes. Almost all of them were men and had diabetes for an average of 10 years.

When they analyzed their medical records for an average of two years after treatment start, the researchers found that the non-surgical group did not lose weight, while those in the surgery group lost an average of about 15 pounds. HbA1c for the surgery group fell from an average of 7.25 percent to 5.98 percent. HbA1c in the medication group did not significantly change after two years. 

In addition, 76 percent of those in the surgery group took fewer medications for their diabetes two years after the surgery.

"This research highlights the benefits of a surgical approach such as sleeve gastrectomy to help improve diabetes outcomes," Greenberg said in a press release, “especially compared to more conservative medical management.”

She also noted that the improvement in diabetes for those who underwent surgery reached a plateau at the end of two years and did not continue to improve. Nevertheless, she said the surgery has the advantage of providing immediate benefits that can jump-start the patient onto a healthier lifestyle.