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Metabolic Surgery Effective for Long-Term T2DM Control

MONDAY, Jan. 25, 2021 -- For individuals with type 2 diabetes, metabolic surgery is more effective than medical therapy for long-term control, according to a study published in the Jan. 23 issue of The Lancet.

Geltrude Mingrone, M.D., from the Fondazione Policlinico Universitario Agostino Gemelli IRCCS in Rome, and colleagues conducted a 10-year follow-up study of a randomized, controlled trial involving patients with type 2 diabetes who were randomly assigned to medical therapy, Roux-en-Y gastric bypass (RYGB), or biliopancreatic diversion (BPD). Diabetes remission at two years was the primary end point of the study. Sixty patients were included, and 57 were followed up at 10 years.

The researchers found that 37.5 percent of all patients treated surgically maintained diabetes remission throughout the 10-year period. In the intention-to-treat population, 10-year remission rates were 5.5, 50.0, and 25.0 percent for medical therapy (one patient went into remission after crossover to surgery), BPD, and RYGB, respectively. During follow-up, 58.8 percent of the 34 patients who were in remission at two years had a relapse of hyperglycemia; however, all those with relapse maintained adequate glycemic control at 10 years. Fewer diabetes-related complications occurred in the RYGB and BPD groups versus the medical therapy group (relative risk, 0.07).

"Metabolic surgery is arguably the most effective available therapy for type 2 diabetes and can be a life-saving option for many patients," a coauthor said in a statement. "It should be appropriately prioritized in times of pandemic and beyond."

Several authors disclosed financial ties to the pharmaceutical and medical device industries.

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Posted: January 2021

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