Gastrointestinal surgery may offer cure for diabetes — Study


Angela Onwuzoo

A new study suggests that gastrointestinal surgery could offer a ‘cure’ for diabetes, even as medical experts say there is no cure yet for the noncommunicable disease.

The study, by researchers from King’s College London and the Fondazione Policlinico Universitario Agostino Gemelli , Rome, Italy, report the outcome of a 10-year trial that compared metabolic surgery with conventional medical and lifestyle interventions in patients with type 2 diabetes.

The study, published in Science Direct, also shows that over one-third of surgically-treated diabetic patients remained diabetes-free throughout the 10-year period of the trial.

“This demonstrates, in the context of the most rigorous type of clinical investigation, that a cure for type 2 diabetes can be achieved”, the researchers said.

The study involved 60 patients with advanced type 2 diabetes and treated at a major academic hospital in Rome, Italy.

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According to the researchers, the patients randomly underwent drugs plus lifestyle interventions or metabolic surgery (gastric bypass or biliopancreatic diversion).

They explained, “At the start of the study, all patients had severe disease, with poorly controlled blood sugar levels and more than five years of history of diabetes.

“The results of the study show that 37.5 percent of surgically-treated patients were able to maintain non-diabetic glycaemia without need for diabetes medication — a condition referred to as diabetes remission — for the duration of the 10-year study period.

“The study investigated the early and long-term safety of the different intervention strategies. Patients who underwent biliopancreatic diversion had more incidences of serious adverse events, including events associated with both disease and intervention, compared to subjects in both other groups.

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“Patients treated by conventional medical therapy had significantly higher incidence of serious adverse events compared to patients who underwent surgery by Roux-en-Y gastric bypass.”

In 2009, American Diabetes Association defined “cure” of diabetes as a continued state of disease remission for more than five years.

Senior Author of the study and Chair of Bariatric and Metabolic Surgery at King’s College London and a Consultant Surgeon at King’s College Hospital in London, Prof. Francesco Rubino, said, “The findings from this study provide the most robust scientific evidence yet that full-blown type 2 diabetes is a curable disease, not inevitably progressive and irreversible.

“ In addition to representing a major advance in the treatment of diabetes, metabolic surgery is our best lead to the elusive cause of the disease.

“Compared to conventional medical treatment, surgery also resulted in better overall metabolic control, lower cardiovascular risk, better kidney function and quality of life.

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“Notably, patients treated surgically had a significant lower incidence of diabetes-related complications, including cardiac, renal, and neurological adverse events. Metabolic surgery also reduced medication usage, including drugs for diabetes, high blood pressure and dyslipidemia.

“Metabolic surgery is arguably the most effective available therapy for type 2 diabetes and can be a life-saving option for many patients. It should be appropriately prioritized in times of pandemic and beyond.”

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