Obesity Management

Diabetes Spotlight

Diabetes picture

The link between obesity and T2DM

It is clear that there is a strong link between T2DM and obesity. Evidence suggests that bariatric and metabolic surgery changes the chemical signals between the stomach, intestine, brain and liver– changing the underlying mechanisms of diabetes.

Recent research from the Cleveland Clinic, called STAMPEDE,* showed that gastric bypass and sleeve gastrectomy surgeries were more effective than intensive medical treatment alone in managing uncontrolled T2DM in overweight or obese patients. The authors of the study concluded that:

"Bariatric surgery represents a potentially useful strategy for the management of uncontrolled type II diabetes, capable of completely eliminating the need for diabetes medication in some patients and a marked reduction in need for drug treatment in others"312

Findings indicated that, at one-year post-surgery, in patients who had metabolic and bariatric surgery:

  • 77% of diabetes was completely "resolved," defined as no longer taking diabetes medications.310
  • 86% of diabetes medications were reduced or no longer used.310
  • In gastric bypass patients, diabetes medications were no longer needed in nearly 84% of patients and were substantially reduced or no longer needed in 93%.310

Worldwide clinical evidence

There have been a large number of significant clinical findings highlighting the advantages of bariatric and metabolic surgery for the treatment of T2DM compared to other treatment options. Some of these studies are:

  • STAMPEDE* – Year 1 results published in the NEJM, March, 2012. The conclusion was that surgical treatment and medications achieved glycemic control in more patients than medical therapy alone.312,315
  • Mingrone – NEJM, April, 2012. The conclusion was that bariatric surgery resulted in better glucose control than did medical therapy.112
  • Buchwald* – American Journal of Medicine, 2009. The conclusion was that T2DM was resolved or improved in 87% of patients following bariatric surgery.313
  • Klein – Obesity, 2011. The conclusion was that T2DM was resolved or improved in 87% of patients following bariatric surgery.313
  • Bolen* – Obesity Surgery, 2012. The conclusion was that there is a lower proportion and likelihood of having T2DM at 5 years post bariatric surgery.314
  • Swedish Obesity Subjects – NEJM, 2012. The conclusion is that bariatric surgery appears to be markedly more efficient than usual care in the prevention of T2DM in an obese person.311
  • Swedish Obesity Subjects – NEJM, 2012. There was a 78% reduction in the risk of developing T2DM following bariatric surgery.311
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Site References

  • * Study funded by Ethicon, Inc.
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