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Bariatric surgery in obese type 2 diabetes patients shows greater remission than lifestyle changes

Obese patients with type 2 diabetes that underwent bariatric surgery had greater remission of the disease than through lifestyle changes alone, a new trial reports.
The findings come from the University of Pittsburgh, who randomly assigned 61 obese adults with type 2 to one of two weight loss procedures, or lifestyle intervention.
The first surgical treatment was a Roux-en-Y-gastric bypass (RYGB), while the second was a laparoscopic adjustable gastric banding (LAGB). Lifestyle interventions were administered to this group in years two and three.
40 per cent of those who underwent RYGB, and 29 per cent who had LABG achieved remission from type 2 diabetes. After three years, these participants no longer required medication. None of the lifestyle treatment group experienced remission.
65 per cent of RYGB, 33 per cent of LAGB and none of the lifestyle only group went from using insulin or oral medication before the study to not needing medication after three years.
Regarding weight loss, the greatest average reduction after three years was found in the RYBG group, at 25 per cent. This figure was 15 per cent in the LAGB group, and 5.7 per cent in the lifestyle treatment group.
The authors noted: “This study provides further important evidence that at longer-term follow-up of three years, surgical treatments, including RYGB and LAGB, are superior to lifestyle intervention alone for the remission of T2DM in obese individuals, including those with a BMI between 30 and 35.”
Study limitations
However, the authors added that more research needs to be done regarding surgery in individuals who are less overweight. Questions also still remain about the impact of bariatric surgery in treating long-term microvascular and macrovascular complications.
Another limitation of the study’s findings was that the lifestyle intervention group involved adopting a low-fat diet, along with exercise. Low-fat diets can be helpful in achieving weight loss, but do not affect blood glucose levels to the degree that remission can be experienced.
Conversely, studies have shown that low-carbohydrate and very low-calorie diets have a greater efficacy in achieving remission from type 2 diabetes.

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