MedicalResearch.com Interview with:
Jan Peter Yska, PharmD
Medical Centre Leeuwarden
Department of Clinical Pharmacy & Clinical Pharmacology
Leeuwarden The Netherlands
Medical Research: What is the background for this study?
Dr. Yska: Many patients with morbid obesity have known type 2 diabetes mellitus. Bariatric surgery effectively prevents and treats type 2 diabetes. A growing number of studies suggests that surgical treatment for obese patients may be considered an additional treatment option for the management of type 2 diabetes. However, an observational study on the remission of type 2 diabetes, using strict criteria for remisson of diabetes, after different types of bariatric surgery, based on data from general practice has not been carried out yet.
Medical Research: What are the main findings?
Dr. Yska: Our study included 569 obese patients with type 2 diabetes who had different types of weight-loss surgery and 1,881 similar diabetic patients who didn’t have surgery. This study confirms that bariatric surgery is successful in treating diabetes mellitus type 2. Per 1,000 person years 94.5 diabetes remissions were found in patients who underwent bariatric surgery, compared to 4.9 diabetes remissions in matched controls. A strict definition of remission of diabetes was used, much stricter than in other studies: patients should have stopped all diabetic medications with an HbA1c < 6.0% after at least 6 months of follow-up. Diabetic patients who underwent bariatric surgery had an 18-fold increased chance of diabetes remission, compared to diabetic patients who did not undergo surgery, with the greatest effect size observed for gastric bypass (adj. RR 43.1), followed by sleeve gastrectomy (adj. RR 16.6), and gastric banding (adj. 6.9). The largest decrease in HbA1c and blood glucose levels was observed in the first two years after bariatric surgery.
Medical Research: What should clinicians and patients take away from your report?
Dr. Yska: Although the risks and possible adverse effects of bariatric surgery shoud be weighed against its benefits, bariatric surgery and, in particular gastric bypass or sleeve gastrectomy may be considered a new treatment option for type 2 diabetes mellitus in patients with a BMI of 35 or greater.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Yska: Future research should focus on the long-term effects (> 5 years) of bariatric surgery on the remission of type 2 diabetes mellitus.
Yska J, van Roon EN, de Boer A, et al. Remission of Type 2 Diabetes Mellitus in Patients After Different Types of Bariatric Surgery: A Population-Based Cohort Study in the United Kingdom. JAMA Surg.Published online September 30, 2015. doi:10.1001/jamasurg.2015.2398.
Jan Peter Yska, PharmD (2015). Study Confirms Bariatric Surgery Success In Treating Type2 Diabetes