Recently, there were two very significant papers showing the highest level of evidence – a prospective randomized study, evaluating the benefit of bariatric surgery in the treatment and/or resolution of type 2 diabetes in morbidly obese patients. The outcome of bariatric surgery was compared to the outcome of best-optimized medical therapy and shows statistically significant superiority of bariatric surgery in treating those conditions. These recent articles shed a new light on the benefits of bariatric surgery and provide a high level of evidence of the superiority of surgery in treating type 2 diabetes in morbidly obese patients.

The first study is from the Bariatric and Metabolic Institute of the Cleveland Clinic, and it follows the outcomes between patients undergoing either weight loss surgery or weight loss medical therapy. After a period of 12 months from the day of surgery or the start of medical therapy, it was seen that “…changes in body weight, BMI, waist circumference, and waist-to-hip ratio were greater after gastric bypass or sleeve-gastrectomy than after medical therapy alone” (Schauer, et al.). Furthermore, the patients with uncontrolled type 2 diabetes who underwent bariatric surgery achieved significantly greater glycemic control than those in medical therapy. “The use of drugs to lower glucose, lipid, and blood pressure levels decreased significantly after [weight loss] surgical procedures, but increased in patients receiving medical therapy only” (Schauer, et al.). The study has provided evidence that surgical treatment for weight loss is also an effective treatment for improving or resolving other obesity-related health issues (comorbidities).

The second study, from the Department of Internal Medicine and Surgery of the Universita Cattolica S. Cuore, also focused on the treatment of type 2 diabetes via bariatric surgery or conventional medical therapy in morbidly obese patients. It was found that surgery resulted in better glucose control than medical therapy alone. Particularly, the mechanism of Roux-en-Y gastric bypass “…markedly ameliorated diabetes in morbidly obese patients…often [resulting] in disease remission” (Mingrone, et al.). In the study, the patients were followed for two years. At 2 years, 75% of the patients in the gastric bypass group had their diabetes resolved completely, with significant improvement in the control of diabetes in the other 25% of the bypass patients; however, the medical therapy group had no patients with diabetes remission. The study’s findings indicate that bariatric surgery is more effective than nonsurgical medical therapy in treating and controlling type 2 diabetes in severely obese patients.

Below we have included the abstracts from the two studies. Please take a moment to read them through, or if you like, you can follow the web URL at the bottom of this page. These will lead you to the full paper. In summary, scientific evidence suggests again and again that conservative therapy for morbid obesity is unsuccessful and only surgery is likely to provide patients with significant and sustained weight loss and improvement and resolution of obesity related medical problems – including Type II diabetes