Gastric bypass surgery RYGB can give you a better control of type 2 diabetes and obesity than lifestyle modification
Even though it is possible to reduce the body weight and high blood glucose levels by participating in an intensive lifestyle modification program, it is difficult to stick to those measures for a longer period. The following options are available for a severely obese patient with a poorly controlled diabetes to reduce blood glucose levels.
The current guidelines suggest a Bariatric surgery to reduce body weight for people with a body mass index (BMI) of over 40 kg/m2 or for people with obesity-associated diseases such as type 2 diabetes (T2D) with a body mass index (BMI) over 35 kg/m2. Earlier studies show a reversal of type 2 diabetes with a Bariatric surgery among obese people having high blood sugar levels. But some health care professionals hesitate to recommend a Bariatric surgery to patients with type 2 diabetes with mild obesity.
But this trial shows patients with an uncontrolled (or a poorly controlled) blood glucose levels and with mild obesity can be benefited from the Bariatric surgery.
A three-year-long randomized SLIMM-T2D (Surgery or Lifestyle with Intensive Medical Management in the Treatment of Type 2 Diabetes) study has found that 58 percent of those patients who underwent a bypass surgery called Roux-en-Y gastric bypass (RYGB) has achieved A1C levels of less than seven percent when compared to 11 percent of patients who underwent Joslin's Why WAIT intensive lifestyle management program.
Other improvements are a reduction in the risk of cardiovascular disease and improvement in the obesity-related quality of life. Researchers from both Joslin Diabetes Center and Brigham and Women's Hospital have conducted this study.
Researchers have conducted a randomized study among 38 obese persons with type 2 diabetes (15 men and 23 women), aged between 46 and 58 years with a body mass index between 33 and 44 kg/m2. Researchers randomly selected 19 patients to the laparoscopic Roux-en-Y gastric bypass RYGB and the remaining patients to the Intensive Medical Diabetes and Weight Management (IMWM).
Patients under medical diabetes and weight-management program have participated in the exercise programs, changed their diet, took medications to increase the weight loss and participated in the educational classes. All of them have high blood sugar levels (HbA1c levels between 7.2 and 9.8). Researchers assessed following health parameters.
Researchers used following tools in the study
The study results show
Authors say their study shows even a patient with type 2 diabetes with mild to moderate obesity, gastric bypass surgery can help in achieving sustained weight loss, reducing cardiovascular risk and HbA1c levels (improved diabetes management) compared to medical diabetes and weight management program. Medical diabetes and weight management program include lifestyle modifications such as eating healthy and low glycemic index foods, regular exercise, avoiding alcohol and smoking and reducing stress etc.
Lead author of the study was Donald C. Simonson, MD, MPH, ScD, Lecturer on Medicine, Brigham and Women's Hospital, Boston, United States. Co-authors of the study were Allison B. Goldfine, Ashley Vernon, Florencia Halperin and Kathleen Foster. The study findings were published February 2018 in the Diabetes Care. Title of the article was "Clinical and Patient-Centered Outcomes in Obese Patients With Type 2 Diabetes 3 Years After Randomization to Roux-en-Y Gastric Bypass Surgery Versus Intensive Lifestyle Management: The SLIMM-T2D Study."
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Published by Jammi Vasista, Chennai, India.