The Wallstreet Journal recently published an article on July 1st that reflected on the growing body of evidence that suggests that weight-loss may be an effective way to treat type-2 diabetes, in conjunction with Dr. Gagner’s editorial companion piece published in the JAMA Surgery Journal.
According to a small but rigorous randomized trial published by JAMA Surgery, evidence shows baratric surgery is superior to lifestyle changes in resolving type-2 diabetes. In the trial, obese patients were randomly assigned either a Roux-en-Y gastric bypass, a laproscopic adjustable gastric banding, or a lifestyle weight loss intervention plan. Results showed that patients who had had the Roux-en-Y gastric bypass procedure had the highest type-2 diabetes partial or complete remission rate with 40%; 29% with the laparoscopic banding; 0% with weight loss intervention patients. In other words, no one in the group who received intensive lifestyle intervention resolved their diabetes, which stands in stark contrast to those who received weight-loss surgery.
If the JAMA Surgery study didn’t convince you, Dr. Gagner points to another study – the TODAY clinical trial on adolescents with recent-onset type-2 diabetes similarly indicates no benefits of intensive lifestyle intervention. For Obese patients with type-2 diabetes, surgery resulted in better glucose control than did medical therapy.
Dr. Gagner states – “We should consider the use of bariatric (metabolic) surgery in all severely obese patients with T2DM and start a mass treatment, similar to what was done with coronary artery bypass graft more than 50 years ago.”