Weight-loss surgery to be the most effective treatment of type two diabetes

weight-loss surgery to be the most effective treatment of type two diabetes when compared to medical management, over the course of five full years evaluation and follow-up. In the study by Hsu, (JAMA Surg 2015 Sept 16:1-8) the authors report experience with matched cohorts of patients with type two diabetes mellitus in the mild to moderate obesity range. In one group, 52 patients had weight-loss surgery consisting of either the laparoscopic sleeve, or the laparoscopic gastric bypass, and their results were compared to 299 matched controls undergoing intensive medical management of their diabetes without surgery. The two groups were the same in terms of the average age, BMI, and duration of diabetes. Over the course of five years, the surgery group proved superior in every measure, resulting in lower hemoglobin A1c measurements, less medication usage, in addition, the surgical patients started at an average BMI of 31 and sell to an average BMI of 24.5 at the end of five years. The hemoglobin A1c decreased from 9.1% 26.3% of five years. 36% of surgical patients had complete remission of their diabetes and an additional 28% and partial remission. In the medical group, the BMI remained unchanged Combo starting at 29 and remaining there, likewise the hemoglobin A1c stayed similar from 8.1% to 8%. 9 people in the medical management arm had died at five years, versus 1 person who died in the surgical group in five years. The authors conclude that metabolic surgery lasts at least five years and is a superior method of treatment of diabetes in this patient population. With the increased safety and simplicity of laparoscopic sleeve procedures, we expect increasing adoption of this intervention in the treatment of type two diabetes in individuals with mild to moderate obesity, BMI 25 to 35. Kent C. Sasse, M.D., MPH, FACS, FACRS Assistant Clinical Professor, University of Nevada School of Medicine Minimally Invasive Solutions]]>