In a 10-year follow-up study of an open-label, single-centre, randomised controlled trial, researchers from the Gemelli University Hospital in Rome suggest that bariatric surgery – also referred to as weight-loss surgery, may be an effective long-term option compared to standard medical treatment for people with type 2 diabetes (T2D).
The 60 study participants, all of whom had been living with T2D for at least 5 years, had an HbA1C greater than 7 and had a body mass index (BMI) of greater than 35, were randomly assigned to three groups: either Roux-en-Y gastric bypass (RYGB) or biliopancreatic diversion (BPD), both forms of bariatric surgery or the third groups which received standard diabetes treatment including medication and dietary and lifestyle modifications.
The endpoint of the original study was diabetes remission at 2 years (defined by HbA1c less than 6·5% and fasting glycaemia less than 5·55 mmol/L without ongoing medication for at least 1 year).
The 10-year follow-up study showed that participants who were surgically treated significantly maintained greater diabetes remission at 10 years (RYGB 25% and BPD 50%) compared to those with non-surgical intervention (5.5%).
Participants in the RYGB and BPD groups also had fewer diabetes-related complications than those in the medical treatment group.
While further long-term research is needed, findings from the Italian study suggests that bariatric surgery may be effective in the long-term management of type 2 diabetes. Currently, bariatric surgery is offered in Australia for weight reduction with or without diabetes and is not currently recommended for the management of diabetes alone. This research does not include results from gastric sleeve surgery, a type of bariatric surgery also offered in Australia. Bariatric surgery should only be considered under medical advice, as it does not come without risks, and will not be a suitable option for everybody.