Half of the patients treated with weight-loss surgery in the study were diabetes-free at five years, said Dr.
In 2009, he and his colleagues randomly assigned 20 obese patients with type 2 diabetes to receive medical treatment, 20 to receive a type of weight-loss surgery called a gastric bypass, and another 20 to undergo a weight-loss operation called a biliopancreatic diversion.
Eighty percent of patients who had surgery had their blood sugar under good long-term control, versus about 25 percent of patients treated with drugs only.
The improvements in blood sugar control and heart disease risk werena€™t related to how much weight patients lost.
Still, doctors are increasingly referring to this type of surgery as a€?diabetes surgery,a€? rather than obesity surgery, said Dr.
Currently the National Institutes of Health states that patients should have a BMI of 40, or a BMI of 35 with obesity-related illness, such as type 2 diabetes, in order to be eligible for weight loss surgery.


Francesco Rubino of Kings College London in the UK and colleagues in a report in The Lancet. But the surgery-treated patients had a 50 percent lower risk of heart and blood vessel disease than those treated with drugs only, and they needed fewer drugs for treating high blood pressure or high cholesterol. An international study published earlier this, for example, found that after two years, people randomized to have gastric bypass surgery had better control of their type 2 diabetes than people assigned to a medication group, but they also had a higher risk for infections and bone fractures. Philip Schauer, the director of the Cleveland Clinic Bariatric and Metabolic Institute and a bariatric surgeon, in a telephone interview with Reuters Health. Schauer pointed out that about half of patients with type 2 diabetes are unable to control their blood sugar with medication and lifestyle measures. What is known, he added, is that the intestines produce a host of hormones involved in regulating metabolism.


Based on the new findings, he said, bariatric surgery should be offered to these patients if they are moderately obese, for example with a body mass index (BMI) of 35.
Reconstructing the gastrointestinal tract so that food bypasses the stomach and small intestine may help restore normal metabolic control, he explained.



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