Lancet: Metabolic surgery promises hope for a cure for type 2 diabetes!

Follow-up analysis data from a randomized controlled trial showed that weight loss surgery was more effective in long-term control of type 2 diabetes (T2DM) than traditional medical treatment, with 37.5 percent of patients undergoing surgery maintaining HbA1c until 7.0 percent after 10 years.
the study was published in the latest lancet.
means there is hope for a cure for type 2 diabetes, which is thought to require lifelong medication.
(DM) is considered one of the four noncommunicable diseases by the World Health Organization (WHO).
, there are currently 463 million DM patients worldwide.
according to the latest global DM map (9th edition) published on the website of the International Diabetes Federation (IDF) in 2019, there are currently 463 million DM patients worldwide, with one in 11 adults (20-79 years old) suffering from DM.
, China has the largest number of DM patients, with about 116 million patients.
projected to reach 578.4 million DM patients worldwide by 2030.
as one of the top 10 causes of death, 4.2 million people aged 20-79 died from DM or its complications in 2019 alone, equivalent to one death from DM every eight seconds, or about 11.3 percent of all deaths worldwide.
2019, global DM-related health spending will be about $760 billion.
for type 2 diabetes (T2DM), which accounts for about 90% of DM, the main pathological feature is insulin resistance (tissues or organs do not respond adequately to normal concentrations of insulin).
, obesity is a major risk factor for T2DM.
this, a team of scientists from The Chinese Medical University in Taiwan and the Stem Cell Research Institute at Harvard University in the United States successfully used the latest CRISPR-Cas9 for gene biomass.
potential treatment has the potential to transform white fat cells and is expected to be a treatment strategy for obesity and diabetes.
metabolic surgery to treat diabetes, is a kind of "new thing", it originated from an accidental scientific observation, but in obesity, diabetes incidence and the emergence of bio-chemical today, has been a practical leap forward development.
, metabolic surgery is now strictly adaptive in most countries, with less than 1% of surgical candidates eventually able to perform metabolic surgery.
" study provides the strongest scientific evidence yet that T2DM is a curable disease, not a perverse and irreversible one.
In addition, metabolic surgery is the best clue to the elusive cause of diabetes treatment," said Francesco Rubino, M.D., chairman of weight loss and metabolic surgery at King's College London.
trial, which began 10 years ago at a level 3 hospital in Italy, aims to compare follow-up 10 years after surgical treatment with medication for T2DM.
60 seriously ill T2DM patients were included between April 2009 and October 2011.
patients had more than five years of diabetes, poor blood sugar levels (HbA1c;7.0%) and a BMI of ≥35 kg/m2.
patients were randomly grouped 1:1:1 for drug plus lifestyle intervention or different metabolic surgery (gastric bypass surgery (RYGB) or bile pancreatic reflow (BPD).
of the study was diabetes remission after 2 years (HbA 1c slt;6.5%, an empty stomach blood sugar of 5.55 mmol/L, no ongoing medication for at least 1 year).
10-year analysis, the persistence of diabetes remission was analyzed through intentional therapy (ITT).
results show that the 10-year follow-up rate is 95.0 per cent (57/60).
15 (37.5%) of all patients treated with surgery achieved diabetes remission throughout the 10-year follow-up period.
specifically, the 10-year remission rate for the three ITT groups was 5.5% (95% CI 1.0-25.7%, one participant entered the remission period after cross-cutting to surgery), bpD group 50.0% (95% CI 29.9-70.1%), RYGB group 25.0% (95% CI 11.2-46.9%).
further analysis found that 20 (58.8%) of the 34 participants observed to be in remission over a two-year period had a recurrence of high blood sugar during follow-up (BPD 52.6% (95% CI 31.7-72.7) and RYGB 66.7% (41.7-84.8%)).
, however, all relapsed individuals maintained blood sugar control over a 10-year period (average HbA 1c 6.7%).
, metabolic surgery (including RYGB and BPD) significantly reduced the overall metabolic risk of these patients, including weight and waist circumference, improved insulin resistance, lipids, cardiovascular risk, kidney function, and overall quality of life.
surgery also reduces the use of drugs for a variety of diseases, including those for diabetes, high blood pressure, and abnormal blood lipids.
addition, it is worth noting that patients in the metabolic surgery group had a 93 percent lower risk of diabetes complications, including adverse events in the heart, kidneys and nervous system, compared to medication.
the risk of severe adverse events was higher in participants in the BPD group (BPD vs drug therapy, OR=2.7; RYGB vs drug therapy, OR=0.7).
, these data confirm that metabolic surgery can be a cost-effective treatment that promises to bring more opportunities and options to patients with severe T2DM and obesity.
: Geltrude Mingrone, et al. Metabolic surgery versus conventional medical therapy in patients with type 2 diabetes: 10-year follow-up of an open-label, single-centre, randomised controlled trial. The Lancet, (2021) DOI: 10.1016/S0140-6736 (20) 32649-0MedSci Original Source: MedSci Original Copyright Notice: This website All text, images and audio and video materials indicating "Source: Mets Medicine" or "Source: MedSci Originals" are copyrighted by Mets Medicine and may not be reproduced by any media, website or individual without authorization, and shall be reproduced with the words "Source: Mets Medicine".
all reprinted articles on this website are for the purpose of transmitting more information and clearly indicate the source and author, and media or individuals who do not wish to be reproduced may contact us and we will delete them immediately.
at the same time reproduced content does not represent the position of this site.
leave a message here