Washington: An endocrinologist from India has suggested that modified bariatric surgery such as sleeve gastrectomy should be considered at an earlier stage of Type 2 diabetes, rather than as a last resort.
A new study by Kirtikumar Modi, MD, an endocrinologist at Medwin Hospital, Hyderabad, India, and his team has found that Type 2 diabetes often reverses after modified weight loss surgery, especially when the duration of diabetes is less than 10 years.
Sleeve gastrectomy is a less radical form of restrictive weight loss surgery than gastric bypass, the most common type of bariatric surgery. It reduces the size of the stomach using laparoscopic (“keyhole”) surgery and stomach stapling. Recent research shows that the procedure can resolve or greatly improve Type 2 diabetes in obese patients and even in some diabetic patients who are not obese.
Initially, Modi and co-workers studied 43 patients with Type 2 diabetes who had sleeve gastrectomy with ileal interposition, in which the ileum, a part of the small intestine, is moved closer to the stomach. All patients had poorly controlled diabetes, with an average disease duration of 10 years. On average, their body mass index (BMI) was 33 kg/m2.
After sleeve gastrectomy, 20 (47 percent) of the patients no longer had diabetes, at an average follow-up of 20 months, the researchers reported.
Remission of diabetes was defined as having a hemoglobin A1c level (a measure of blood sugar control over the past three months) below 6.5 percent and no longer needing insulin or oral hypoglycemic agents (blood sugar-lowering medications).
The other 23 patients in this group all needed fewer or smaller doses of oral diabetes medications, Modi said.