Metabolic Surgery for Diabetes Management

In this report, the authors noted that gastric bypass surgery provided exceptional glycemic control for patients with non–insulin dependent type 2 diabetes. Following these foundational observations, there have been multiple prospectiv e trials that have clearly delineated the superior effectiveness of metabolic surgery for glycemic outcomes in patients with type 2 diabetes and overweight or obesity. For instance, the Surgical Treatment and Medications Potentially Eradicate Diabetes Efficiently (STAMPEDE) trial randomized patients with type 2 diabetes to intensive medical therapy or intensive medical therapy with metabolic surgery. This trial demonstrated that metabolic surgery was superior to intensive medical therapy at 3 and 5 years for glycemic outcomes, including reaching hemoglobin A1C (HgbA1C) goals established by the American Diabetes Association. The importance of achieving these HgbA1C thresholds with metabolic surgery is these outcomes translate to reduced long-term cardiovascular complications, like heart failure and coronary artery disease. In a cohort study of nearly 50 000 patients with type 2 diabetes , each 1% increase in HbA1C was associated with an 8% increased risk of new heart failure. The total annual cost of diabetes care in the US in 2022 was $412.9 billion, with $106.3 billion (26%) attributed to lost productivity at work, unemployment from chronic disability, and premature mortality. Co nversely, metabolic surgery in patients with type 2 diabetes...
Source: JAMA Surgery - Category: Sports Medicine Source Type: research