This week in Medscape Physician Newsletter:
Call to Make Bariatric Surgery as Common as Coronary Bypass
Marlene Busko
July 02, 2015
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A single-center study that randomized 61 obese patients with type 2 diabetes to Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding, or an intensive, 1-year lifestyle intervention found that up to 40% of patients who underwent the bariatric surgery had at least partial remission of diabetes at 3 years, compared with no one in the nonsurgical arm.
These results, published online July 1 in JAMA Surgery, extend 1-year findings reported previously by Anita P Courcoulas, MD, from the University of Pittsburgh Medical Center, Pennsylvania, and colleagues.
“This study provides further important evidence that at a longer-term follow-up of 3 years, surgical treatments including Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding are superior to a lifestyle intervention alone for the remission of type 2 diabetes in individuals with obesity, including those with a body mass index [BMI] between 30 and 35 [class 1 obesity],” Dr Courcoulas told Medscape Medical News.
Indeed, she and her colleague say the latter point is one of the most important aspects of this study, as more than 40% of their sample had BMIs of 30 to < 35, “for whom data in the literature are largely lacking.”
Bariatric surgery should therefore be considered for the obese patient with type 2 diabetes, especially those who have difficulty attaining glycemic control, Dr Courcoulas said.
In an accompanying editorial, Michel Gagner, MD, from Florida International University, in Miami, and Hôpital du Sacré-Coeur de Montréal, Quebec, goes even further.
The time has come for bariatric surgery to be as common as coronary artery bypass surgery, he urges. “We should consider the use of bariatric (metabolic) surgery in all severely obese patients with type 2 diabetes mellitus and start a mass treatment, similar to what was done with coronary artery bypass graft more than 50 years ago,” he writes.
F.R.s own “Texas Flower” died from complications following bariatric surgery.
I have found the gut bacteria studies to be very interesting and their role in driving hunger. It seems to make sense. Antibiotics are given routinely to farm animals and it seems nearly all children are given antibiotics at sometime during their childhood.