For people with obesity and uncontrolled diabetes, weight-loss surgery can bring diabetes under control far more effectively than medications, a New England Journal of Medicine study has shown.
The study included 150 people with an average body mass index (BMI) of 36. Obesity is defined as a BMI of 30 or more. Their average HbA1c level (a long-term measurement of blood sugar) was 9.3%. Normal levels range between 4% and 5.6%.
People in the study received either intensive medical therapy for diabetes or weight-loss surgery—either a gastric bypass or a sleeve gastrectomy. A gastric bypass creates a small pouch that bypasses most of the stomach and is then reattached to the small intestine. The sleeve procedure removes about 75% of the stomach, leaving just a vertical tube or sleeve.
After three years, 38% of the people who had gastric bypass reached the HbA1c goal of 6%, compared with 24% in the sleeve gastrectomy group and just 5% of the medical therapy group. Those who got surgery lost much more weight, used fewer diabetes medications, and reported a better quality of life than those in the medical therapy group.