Bariatric surgery tops usual care in Type 2 diabetes

A randomized clinical trial data has shown continued long-term improvement in diabetes outcomes with bariatric surgery compared to medical/lifestyle intervention in people with Type 2 diabetes.

Originally presented in June 2023 at the annual Scientific Sessions of the American Diabetes Association and published in February 2024, the findings come from four trials in the United States where, at seven years of follow-up, 193 people having one of three types of bariatric procedures had lower A1c levels and higher rates of diabetes remission than 96 people receiving medical/lifestyle intervention.

Study Co-author Ali Aminian, MD, director of the Bariatric and Metabolic Institute at the Cleveland Clinic, Cleveland, Ohio, told Medscape Medical News, “We’ve shown that surgery is very durable in terms of diabetes control, in need for diabetes medication, and in weight loss. ”

However, others have pointed out that the four trials were launched well before semaglutide and tirzepatide were approved for Type 2 diabetes and obesity, and that these medications also had the potential to transform the management of both these diseases.

Nevertheless, it is also noted that the up-front costs of the surgery — potentially reaching $33,500 — is generally considered cost-effective, whereas the medications, currently costing more than $1000 per month with the possibility of lifelong use, could far exceed that of surgery.

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