50% achieved diabetes relief in 10 years!

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Introduction: Recently, a 10-year follow-up data analysis published in the "Lancet" magazine shows that bariatric surgery is more effective than drug therapy in the long-term management of the disease in people with type 2 diabetes and obesity.

Professor Geltrude Mingrone, the main person in charge of this research, mentioned: “People are generally skeptical about bariatric surgery at present, but for the management of obesity, the effect is really excellent.

This research is for bariatric surgery for type 2 diabetes.
Long-term disease management of obese patients provides high-quality evidence.

” Mingrone and colleagues analyzed 10-year follow-up data from an open-label, single-center study conducted in a tertiary hospital in Rome.

Among them, participants with type 2 diabetes and obesity [BMI≥35kg/m^2] (n=60) were randomly assigned to medication, Roux-en-Y gastric shunt group or biliary-pancreatic shunt according to 1:1:1 Surgery group.

 The primary study endpoint was the diabetes remission rate at 2 years after receiving treatment (defined as HbA1c≤6.
5%, fasting blood glucose≤5.
5mmol/L, withdrawal for at least 1 year).

In this 10-year analysis, the researchers analyzed the persistence of diabetes remission through intention-to-treat (the 10-year follow-up rate was 95%).

 50% achieved diabetes relief in 10 years! In this cohort, 15 subjects (37.
5%) maintained their diabetes in remission during the 10-year follow-up period.

 ➤The 10-year remission rate of the drug therapy group was 5.
5%; ➤The 10-year remission rate of the biliary-pancreatic shunt group was 50%; ➤The 10-year remission rate of the Roux-en-Y gastric shunt group was 25%.

 Proportion of recurrence of hyperglycemia The researchers observed that of the 34 participants who achieved remission of diabetes in the second year, 20 had recurrence of hyperglycemia during the follow-up period, in the biliary-pancreatic shunt group and Roux-en-Y gastric shunt.
The recurrence rates of hyperglycemia in the group were 52.
6% and 66.
7%, respectively.

All relapsed patients maintained relatively good blood glucose control within 10 years.

 Complications and adverse reactions Roux-en-Y gastric shunt group and biliary-pancreatic shunt group had fewer diabetes-related complications than those who received medication, and the RR was 0.
07 (95% CI, 0.
01-0.
48).

Compared with subjects receiving drug treatment, subjects in the biliary-pancreatic shunt group and Roux-en-Y group had a higher frequency of serious adverse events.

 The clinical outlook researchers believe that in the long-term obesity population with type 2 diabetes, bariatric surgery ensures good blood sugar control, reduces macrovascular and microvascular complications, and improves the quality of life of patients compared with standard care.
improve.

Although a larger multi-center randomized controlled trial is needed to confirm it, at present, bariatric surgery should be regarded as a good treatment option for obese patients with type 2 diabetes with poor blood sugar control.

 References: [1]Mingrone G, et al.
Lancet.
2021; doi:10.
1016/s0140-6736(20)32649-0.
[2]Regina Schaffer.
Bariatric surgery'good therapeutic option' for treating obesity, type 2 diabetes [EB/OL].
2021-4-5.