Research Activities, July 2013
Bariatric surgery effective for treating diabetes in some obese patients
Comparative Effectiveness Research
There is some evidence to suggest that bariatric surgery is effective in the short term for treating diabetes in patients who are obese (body mass index [BMI] of at least 30 but less than 35 kg/m2) based upon blood-glucose (HbA1c) outcomes, according to a new AHRQ research review that was published in The Journal of the American Medical Association on June 5, 2013. Specifically, evidence suggests that laparoscopic adjustable gastric banding, Roux-en-Y gastric bypass, and sleeve gastrectomy are effective for treating diabetes and impaired glucose tolerance.
At 1 year, patients showed greater weight loss than usually seen in studies of diet, exercise, or other behavioral interventions. While short-term harms associated with bariatric surgery appear to be relatively minor in these patients, there is not yet enough data to fully understand all the potential harms. Also, there is not yet enough evidence to determine if surgical intervention is effective in the long term.
Bariatric surgery has consistently been used in populations with a BMI of greater than 40.0 kg/m2 (morbidly obese), and in those patients with a BMI of 35.0 to 39.9 kg/m2 (severely obese), who suffer from significant weight-related comorbidities such as diabetes. In the past few years, bariatric surgery has been suggested as an option for patients with lower BMIs as a way to treat diabetes and other metabolic conditions. While lifestyle interventions such as diet and exercise can be effective in reducing obesity and other weight-related issues like diabetes, heart disease, and hypertension, some people with lower BMIs may benefit from surgical intervention to address these potentially life-threatening comorbidities.
These findings can be found in the research review, Bariatric Surgery and Nonsurgical Therapy in Adults With Metabolic Conditions and a Body Mass Index of 30.0 to 34.9 kg/m². You can access the review at http://go.usa.gov/bdUT.