The results of the longest follow-up randomized clinical trial to date show that metabolic surgery is more effective than drug therapy and lifestyle interventions in the long-term management of severe type 2 diabetes.
Study published today LancetAlso shows that more than one-third of patients who received surgical treatment remained diabetes-free throughout the 10 years of the study. This shows that a “cure” of type 2 diabetes can be achieved in the context of the most rigorous types of clinical research.
Researchers at King’s College London and Fondazione Polyclinico Universitario Agostino Gemmeri IRCCS, Rome, Italy have conducted a 10-year study comparing traditional medical and lifestyle interventions with metabolic surgery in patients with type 2 diabetes. Is reporting.
The study enrolled 60 patients with advanced type 2 diabetes and was treated at a major academic hospital in Rome, Italy. Patients randomly underwent drug and lifestyle interventions or metabolic surgery (gastric bypass or biliary pancreatic bypass). At the beginning of the study, all patients had severe illness with poorly controlled blood sugar levels and a history of diabetes for more than 5 years.
The results of this study show that 37.5% of patients who received surgical treatment were able to maintain non-diabetic blood glucose during the 10-year study period without the need for antidiabetic drugs (a condition called diabetic remission). is showing. In 2009, the American Diabetes Association defined the “cure” of diabetes as a state of remission of a disease that lasted more than five years.
Professor Francesco Rubino, senior author of the report, chair of Barrier Trick and Metabolic Surgery at King’s College Hospital in London, and consultant surgeon at King’s College Hospital in London, said: 2 Diabetes is a curable disease that is not necessarily progressive and irreversible. In addition to representing major advances in the treatment of diabetes, metabolic surgery is the best lead to the elusive causes of the disease.
Compared to traditional treatments, surgery has also resulted in better overall metabolic control, lower cardiovascular risk, better renal function and better quality of life. In particular, surgically treated patients had a significantly lower incidence of diabetes-related complications, including cardiac, renal, and neurological adverse events. Metabolic Syndrome has also reduced the use of medications, including medications for diabetes, hypertension, and dyslipidemia.
This study investigated the initial and long-term safety of various intervention strategies. Patients who underwent biliary pancreatic duct conversion had a higher incidence of serious adverse events, including events related to both disease and intervention, compared to subjects in both other groups. Patients treated with conventional medical treatment had a significantly higher incidence of serious adverse events than those who underwent surgery with Roux-en-Y gastric bypass.
The first author of the report, Professor Geltrude Mingrone, Professor of Medicine at the Catholic University of Rome, and Professor of Diabetes and Nutrition at King’s College London, said: 2 diabetes. Currently, there is compelling evidence that metabolic surgery should be considered as the primary treatment option for treating patients with severe type 2 diabetes and obesity. “
Previous studies have shown that weight loss surgery or weight loss surgery can induce long-term remission of diabetes in patients with very severe obesity. However, most patients undergoing traditional weight loss surgery usually have mild or recently developed diabetes. This study demonstrates the potential therapeutic effect of metabolic surgery on patients with severe illness.
Diabetes is one of the leading causes of mortality and morbidity in Western societies and significantly increases the risk of death from severe COVID-19 and the virus. Despite evidence that surgery can improve diabetes quickly and dramatically, less than 1% of surgery candidates have access to metabolic surgery in most countries. Moreover, during the current pandemic, metabolic surgery has been interrupted for even longer than other selective surgeries.
“Metabol surgery is arguably the most effective treatment available for type 2 diabetes and can be a life-saving option for many patients,” said Professor Rubino. “In the post-pandemic period. It should be prioritized appropriately. ”
Experts warn that delaying obesity and metabolic surgery during the COVID-19 pandemic puts patients at risk
Courtesy of King’s College London
Quote: Gastrointestinal surgery may be a cure for type 2 diabetes, obtained from https://medicalxpress.com/news/2021-01-gastrointestinal-surgery-diabetes-long-January 22, 2021 New long-term study (January 21, 2021) found term.html
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