Surgery Works Better Than Drugs at Blood Sugar Control in Obese Patients

An Ohio-based study of overweight and obese type 2 patients shows that weight loss surgery works much better at controlling blood sugar levels than any known drug treatment.

The study, called STAMPEDE and conducted  by the Cleveland Clinic, compared results among 150 patients who had body mass indexes ranging from 27 (overweight) to 43 (morbidly obese). Their average HbA1C level was 9%.

Researchers divided the patients into three groups: Two of the groups were randomly assigned one of two types of weight-loss surgical procedures and no diabetes drugs. The third group received drugs but underwent no surgery.

The study goal was to see what percentage in each group achieved an A1c of 6% or lower after one year.

Forty-two percent of patients who underwent laparoscopic gastric bypass surgery, which allows food to bypass part of the small intestine, reached the 6% or lower goal.

Thirty-seven percent of patients who underwent sleeve gastrectomy, which dramatically reduces stomach size, achieved the 6% or lower target.

Twelve percent of patients in the drugs-only treatment group reached the goal.

Currently, gastric bypass surgery is limited to patients with a body mass index of 35 or greater-severely obese. But because many bypass patients are and have been type 2s, surgeons have often noticed dramatic improvements in type 2s’ symptoms after the surgeries.

The beneficial effects of the surgeries have created a push among some surgeons and diabetes advocates to make health insurance companies lower the BMI required to qualify a person for bypass surgery coverage. The first part of the push would be lower the qualifying BMI number to 31. A second part would be to extend the bypass surgery option to type 2s on the grounds that the cost of the surgery would be more than repaid by a reduction in the expense of treating type 2s over the course of several decades.

An estimated 80 percent of the 23 million Americans who have type 2 are overweight or obese.

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