People diagnosed with type 2 diabetes experience more benefits to their health through weight loss surgery compared to undergoing a lifestyle change, according to new research by the University of Pittsburg.
In a study published in the journal JAMA Surgery, researchers from Pitt's medical center examined data collected from 61 type 2 diabetes patients between 25 and 55 years old.
Around half of the participants were categorized as class 1 obese, or those who a body mass index (BMI) of 30 to 34.9, while the rest fell under heavier obesity classes.
The researchers then assigned the participants to undergo either an intensive lifestyle intervention for one year followed by a less intensive one for two years, or bariatric (weight loss) surgery.
Weight loss surgeries featured in the study were laparoscopic adjustable gastric banding (lap-band) and Roux-en-Y gastric bypass.
Patients that were assigned to undergo a bariatric surgery were enrolled to a low-intensity lifestyle intervention for two, similar to the one given to the non-surgery group.
The findings showed that 40 percent of participants who had a Roux-en-Y gastric bypass surgery experienced a partial remission of their diabetes after three years, while 29 percent of those who had a lap-band surgery experience a similar improvement of their health during the same period as well.
Those that belonged to the non-surgery group, however, did not show any remission of their type 2 diabetes.
Three participants from the Roux-en-Y gastric bypass group and one from the lap-band group had their diabetes disappear completely, a result that was not seen from any of the participants from the lifestyle group.
Despite being a randomized study, the Pitt researchers said they will need to examine additional patients from other medical facilities over a longer period in order to produce definite conclusions.
The University of Pittsburg study is featured in the JAMA Surgery journal.
Candidates for Bariatric Surgery
Previous studies suggest that patients with obesity related health conditions such as osteoarthritis, high blood pressure, obstructive sleep apnea and type 2 diabetes, can become candidates for weight loss surgery.
These patients are typically more than 100 pounds beyond their ideal body weight and have a BMI rating of over 40.
An individual who has a BMI of over 35 and suffer from severe negative health effects due to obesity, or someone who cannot sustain a healthy body weight for long periods, even with the help of medically-supervised dieting, can be eligible for weight loss surgery.
Candidates must also be between 16 and 70 years old and morbidly obese. Those who have a BMI rating of 35 to 39 can also qualify for the procedure if they suffer from sleep apnea, hypertension, cardiovascular disease and diabetes.
Women who are planning to become pregnant are highly advised not to bear a child within the first 18 months to two years following the weight loss procedure. This is because the nutritional deficiencies as well as the rapid weight loss that follow a bariatric procedure make pregnancy very dangerous for both mother and child.
Bariatric Surgery Procedures
Patients who plan to undergo bariatric surgery are carefully evaluated by doctors to determine which procedure will be appropriate for the candidate.
The most commonly performed restrictive procedure is laparoscopic gastric banding. The surgery involves restricting the amount of food eaten by the candidate by making the stomach smaller. It offers a shorter operating procedure compared to other surgeries, and since it does not require incisions, it results in less scaring and a faster recovery time for the patient.
The malabsorptive procedure most commonly performed by surgeons is the Roux-en-Y gastric bypass. The surgeon reduces the size of the stomach by dividing its upper end to create a small pouch. A Y-shaped section of the small intestines is then attached directly to the pouch so that food can bypass other sections of the digestive tract responsible for absorbing nutrients and calories.
Most people who have weight loss surgery often make a full recovery without developing complications. Roux-en-Y gastric bypass patients are asked to stay in the hospital for about two to four days to recover, while lap-band patients may stay for one to two days.
Weight loss surgery patients can lose from 66 to 80 percent of their excess body weight, typically between 18 and 24 months after the procedure.
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