LONDON — For patients with diabetes, managing their condition can be a lifelong struggle. While many people rely on medication and lifestyle management, a new study finds surgery may actually be the best option. Researchers from King’s College London say metabolic surgery can essentially “cure” patients with severe cases of type 2 diabetes.
In their report, researchers find that over one-third of patients having gastric bypass or biliopancreatic diversion surgery remained diabetes-free throughout a 10-year follow-up period. Study authors say the results prove that a definitive cure for type 2 diabetes can be created.
Teaming with researchers from the Fondazione Policlinico Universitario Agostino Gemelli IRCCS in Rome, study authors followed 60 patients dealing with advanced cases of type 2 diabetes. Researchers randomly selected participants to undergo treatment with drugs and lifestyle interventions or metabolic surgery. Each person in the trial had been experiencing severe symptoms of the disease and poor control over their blood sugar for more than five years.
‘Type 2 diabetes is a curable disease’
The results reveal 37.5 percent of diabetics having metabolic surgery maintained healthy glucose levels after the procedure. These patients did not need medication to manage their levels during the 10-year study window. In 2009, the American Diabetes Association defined a “cure” as any treatment which causes diabetes remission for over five years.
“The findings from this study provide the most robust scientific evidence yet that full-blown type 2 diabetes is a curable disease, not inevitably progressive and irreversible. In addition to represent a major advance in the treatment of diabetes, metabolic surgery is our best lead to the elusive cause of the disease,” says Professor Francesco Rubino, senior study author and Chair of Bariatric and Metabolic Surgery at the School of Life Course Sciences, in a university release.
More reliable than diabetes drugs?
The study finds patients undergoing metabolic surgery enjoyed better metabolic control, lower cardiovascular risk, better kidney function, and a better overall quality of life. Researchers note that diabetics treated surgically also had a lower risk of diabetes-related complications. These include adverse cardiac events, renal problems, and neurological issues.
Additionally, metabolic surgery reduced the need for medications treating diabetes, high blood pressure, and dyslipidemia — an abnormally high amount of cholesterol or fat in the blood.
The news isn’t all good for diabetics opting for surgery. Researchers find patients who had biliopancreatic diversion experienced more cases of serious adverse side-effects compared to patients on diabetes medications or those receiving gastric bypass surgery.
Participants who had a Roux-en-Y gastric bypass however, experienced far fewer side-effects than patients only dealing with diabetes through medication and lifestyle changes.
“These data corroborate the notion that surgery can be a cost-effective approach to treating type 2 diabetes. The evidence is now more than compelling that metabolic surgery should be considered as a main therapeutic option for the treatment of patients with severe type 2 diabetes and obesity,” says Professor Geltrude Mingrone, study first author and Professor of Diabetes and Nutrition at the School of Life Course Sciences.
COVID complicating the search for a diabetes cure
Study authors say bariatric or weight loss surgeries have already been connected to diabetes remission in severely obese patients. Those cases, however, typically involved people with mild cases of the disease. The new study opens the door for treating even the most serious and long-lasting cases of diabetes.
While surgery may be the best option, its availability remains in limbo thanks to the coronavirus pandemic. Researchers say metabolic surgeries have been suspended for even longer periods of time than other elective procedures during COVID-19.
The team adds less than one percent of eligible surgical candidates actually have access to metabolic surgery in most countries.
“Metabolic surgery is arguably the most effective available therapy for type 2 diabetes and can be a life-saving option for many patients. It should be appropriately prioritized in times of pandemic and beyond,” Prof. Rubino concludes.
The study appears in the journal The Lancet.