(Press-News.org) Tuesday, February 27, 2024, CLEVELAND: Research by Cleveland Clinic and three other U.S. medical centers has found that bariatric surgery provides better long-term control of blood glucose levels in patients with obesity and type 2 diabetes, compared with medical therapy.
Study participants who had bariatric surgery also experienced higher rates of complete diabetes remission up to 12 years after their surgical procedure.
The research was published in JAMA.
The Alliance of Randomized trials of Medicine vs Metabolic Surgery in Type 2 Diabetes (ARMMS-T2D) consortium analyzed long-term results of four randomized trials that were conducted at four U.S. centers: Cleveland Clinic (Ohio), Joslin Diabetes Center/Brigham and Women’s Hospital (Massachusetts), University of Pittsburgh (Pennsylvania), and University of Washington/Kaiser Permanente Washington (Washington). About half of the ARMMS-T2D study participants were from Cleveland Clinic.
Ali Aminian, M.D., a co-investigator of the ARMMS-T2D study and the director of Cleveland Clinic’s Bariatric & Metabolic Institute, said: “ARMMS-T2D provides the largest analysis with the longest follow-up in the setting of randomized clinical trial to compare bariatric surgery with medical therapy for the treatment of type 2 diabetes in patients with obesity.”
According to the Centers for Disease Control and Prevention, about 1 in 10 Americans have diabetes and approximately 90% of the diabetes cases in the USA are type 2 diabetes. The chronic condition happens when an individual has persistently high blood sugar levels. Without treatment, type 2 diabetes can cause various health problems, like heart disease, kidney disease, and stroke.
For the ARMMS-T2D, 262 eligible participants were enrolled between 2007 and 2013 and followed until 2022. The medical group included 96 participants and the surgical groups had 166 participants. Patients in the medical group received a variety of medications for the treatment of type 2 diabetes, including FDA-approved incretin/GLP-1 agonists. Those medications help lower blood sugar levels and promote weight loss. Bariatric surgery included gastric bypass, gastric sleeve, and adjustable gastric banding. The average age was 50; 68% of the participants were female; and 67% were white. The average body mass index (BMI) was 36.4.
Researchers reported the change in blood sugar levels – measured in this study as HbA1c level – immediately after surgery up to 12 years. HbA1c is a standard laboratory test that reflects average blood sugar over the past three months. Between the surgical group and the medical therapy group, researchers noted a large difference in HbA1c of 1.4% at seven years and 1.1% at 12 years with bariatric surgery providing superior blood glucose control.
Researchers also looked at diabetes remission over time (defined in this study as a HbA1c level less than 6.5% without need for diabetes medications for at least 3 months). In the bariatric surgery group, 50.8% of the participants achieved remission of diabetes at one year, compared with 0.5% of participants in the medical group. At seven years, 18.2% of the participants in the bariatric surgery group still had remission of their diabetes.
Dr. Aminian said: “The magnitude of benefits of bariatric surgery is very large and durable. Patients with diabetes usually need more medications over time to control their blood glucose. However, a two-hour surgery could help many of them to control their diabetes without needing any medications, including insulin.”
Study results showed that 40% of patients in the bariatric surgery group and only 4% of patients in the medical group were off diabetes medications at seven years.
The use of insulin after bariatric surgery was also significantly lower (16%) than in the medical group (56%) at seven years.
The use of incretin/GLP-1 agonist medications was greater in the medical group across all annual visits.
Researchers also looked at changes in weight over time. During the seven-year follow-up, researchers noted 19.9% weight loss in the surgical group, compared to 8.3% weight loss in the medical group. At 12 years, the bariatric surgery group continued to have superior weight loss (19.3%) compared to the medical group (10.8%).
In the bariatric surgery group, anemia, fractures, and gastrointestinal symptoms were more common. Dr. Aminian said it is important for patients to be treated by a multidisciplinary team, including nutrition specialists, so that the necessary vitamins and supplements can be recommended after bariatric surgery.
Bartolome Burguera, M.D., Ph.D., an endocrinologist and Chief of the Medical Specialty Institute at Cleveland Clinic, said: “Type 2 diabetes and obesity are chronic diseases that need long-term treatment. This study shows that bariatric surgery provides long-term benefits for the treatment of type 2 diabetes in many patients with obesity. We now have recently FDA-approved medications for the treatment of type 2 diabetes – such as semaglutide and tirzepatide – but access to those medications needs to be improved. I think it’s important to discuss with our patients all the available treatment options for type 2 diabetes and obesity so that we can identify the best long-term therapy for each patient.”
During the ARMMS-T2D follow-up, 25% of the study participants that were in the medical group did not want to continue with that treatment and underwent bariatric surgery after a few years. Researchers accounted for that change in their analysis.
ARMMS-T2D is supported by cooperative agreement U01 DK114156 from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
About Cleveland Clinic
Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. Cleveland Clinic is consistently recognized in the U.S. and throughout the world for its expertise and care. Among Cleveland Clinic’s 77,000 employees worldwide are more than 5,658 salaried physicians and researchers, and 19,000 registered nurses and advanced practice providers, representing 140 medical specialties and subspecialties. Cleveland Clinic is a 6,699-bed health system that includes a 173-acre main campus near downtown Cleveland, 23 hospitals, more than 275 outpatient facilities, including locations in northeast Ohio; southeast Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England. In 2022, there were 12.8 million outpatient encounters, 303,000 hospital admissions and observations, and 270,000 surgeries and procedures throughout Cleveland Clinic’s health system. Patients came for treatment from every state and 185 countries. Visit us at clevelandclinic.org. Follow us at twitter.com/ClevelandClinic. News and resources available at newsroom.clevelandclinic.org.
Editor’s Note: Cleveland Clinic News Service is available to provide broadcast-quality interviews and B-roll upon request.
END
Study shows bariatric surgery provides superior long-term treatment for type 2 diabetes in patients with obesity
Twelve-year data indicate greater weight loss and fewer diabetes medications after bariatric surgery compared to usual care
2024-02-27
[Attachments] See images for this press release:
ELSE PRESS RELEASES FROM THIS DATE:
Diet linked to preeclampsia among low-income Hispanic women during pregnancy
2024-02-27
A research study led by the Keck School of Medicine of USC found that certain combinations of foods consumed during pregnancy may be linked to a higher likelihood of developing preeclampsia, a potentially life-threatening blood pressure condition that can have serious consequences for both mother and baby.
The study, which focuses on low-income Hispanic women in Los Angeles, suggests that different combinations of foods in a woman's diet during pregnancy have the potential to increase or reduce the likelihood of preeclampsia development, and that interventions in diet during pregnancy may help reduce the risk of preeclampsia.
It is known that Hispanic women develop ...
Exposure to secondhand smoke during chemotherapy makes treatment less effective, study shows
2024-02-27
People who are diagnosed with head and neck cancer often receive a standard type of chemotherapy as part of their treatment. If they are exposed to secondhand smoke during chemotherapy — even if they have never smoked themselves — the treatment may be far less effective at killing cancer cells. That finding, considered the first of its kind, was revealed in a study recently published by researchers at the University of Oklahoma Health Sciences.
Tobacco use is a well-established risk factor for cancer and a signal of poor outcomes, especially ...
Polar climates changing in fundamental ways
2024-02-27
[Boston, MA—February 27, 2024] Research recently published early online in journals of the American Meteorological Society demonstrates changes at the Earth’s poles, including altered ocean-sea ice dynamics, dampened temperature extremes, and differing responses to solar radiation at the north and south poles, and suggests that long-term warming trends may have played more of a role in 2023’s record-low Southern Ocean ice than previously supposed.
Three papers in the Journal of Climate (JCli) find that the Arctic and Antarctic appear to be adjusting to a warming climate with fundamental changes in regional climate dynamics.
The Antarctic ocean-sea ice system may be fundamentally ...
Remote online genetic education programs can spur testing for inherited susceptibility to cancer, study suggests
2024-02-27
Even as it's become clear that an inherited susceptibility to some cancers is more common than once thought, genetic testing of family members of cancer patients hasn't increased as much as experts had hoped. A new study led by researchers at Dana-Farber Cancer Institute and Brigham and Women’s Hospital demonstrates that a remote online genetic education program can be a powerful motivator for people with a family history of cancer to undertake genetic testing.
The GENetic Education, Risk Assessment, and TEsting (GENERATE) study included 601 people from across 45 states who had a close relative with the most common form of pancreatic cancer. Participants ...
Study shows daylight saving time has minimal effect on heart health
2024-02-27
ROCHESTER, Minn. — A recent Mayo Clinic study examining the effects of daylight saving time (DST) on heart health suggests that the impact is likely minimal.
In the nationwide study, researchers applied an advanced statistical model to look for any connections between DST and serious cardiovascular problems, including heart attacks and strokes. The study looked at 36,116,951 adults aged 18 and up across most U.S. states. (Arizona and Hawaii were excluded since these states do not observe DST.)
Researchers focused on the week directly after the spring and fall DST transition, ...
New disease testing component facilitates lower-cost diagnostics
2024-02-27
A new tool could reduce costs for diagnosing infectious diseases.
Biomedical researchers from The University of Texas at Austin have developed a new, less expensive way to detect nuclease digestion – one of the critical steps in many nucleic acid sensing applications, such as those used to identify COVID-19 and other infectious diseases.
A new study published in the journal Nature Nanotechnology shows that this low-cost tool, called Subak, is effective at telling when nucleic acid cleavage occurs, which happens when an enzyme called nuclease breaks down nucleic acids, such as DNA or RNA, into smaller fragments.
The traditional way of identifying nuclease ...
White House includes two Tufts-related initiatives in commitments to end hunger, reduce diet-related disease
2024-02-27
Two Tufts-related initiatives have been included in the White House’s new round of public and private sector commitments, announced today by the Biden-Harris administration, to end hunger, improve nutrition, and reduce diet-related disease in the United States by 2030. The White House Challenge to End Hunger and Build Healthy Communities continues the Biden-Harris administration’s work started at the historic White House Conference on Hunger, Nutrition, and Health that was held in September 2022, encouraging stakeholders from all corners to develop bold commitments to help achieve the administration’s five key pillars of national ...
U of M-led research identifies predictor of outcomes, chemoresistance for ovarian cancer patients
2024-02-27
MINNEAPOLIS/ST. PAUL (2/27/2024) — In a major scientific breakthrough, newly published research from an international consortium led by the University of Minnesota’s Masonic Cancer Center has the potential to transform the landscape of ovarian cancer treatment.
Published today in JAMA Network Open, the findings indicate that ovarian cancer patients with high levels of stroma within their tumors are twice as likely to exhibit chemoresistance to the conventional standard of care. Stroma is the non-cancerous tissue that provides support to tumors.
The ...
NRG Oncology announces new leadership of Canadian Members Subcommittee
2024-02-27
NRG Oncology, a National Cancer Institute (NCI) National Clinical Trials Network (NCTN) group focused on improving outcomes for adults with cancer through multi-center clinical research, recently announced a new Chair and Vice Chair of the organization’s Canadian Members Subcommittee.
The NRG Canadian Members Subcommittee is tasked with engaging and supporting NRG’s Canadian member institutions through their participation in NRG research. This subcommittee was created to tackle the unique regulatory, administrative, and ...
Bariatric surgery provides long-term blood glucose control, type 2 diabetes remission
2024-02-27
BATON ROUGE – People with type 2 diabetes who underwent bariatric surgery achieved much better long-term blood glucose control compared to people who received medical management plus lifestyle interventions, according to a new study published in JAMA, or Journal of the American Medical Association, and funded by the National institute of Diabetes, Digestive and Kidney Diseases, part of The National Institutes of Health.
In addition, participants who underwent bariatric surgery, also called metabolic or weight-loss surgery, were more likely to stop needing diabetes medications and had higher rates of diabetes remission up to 12 years post-surgery. ...
LAST 30 PRESS RELEASES:
Preschool education: A key to supporting allophone children
CNIC scientists discover a key mechanism in fat cells that protects the body against energetic excess
Chemical replacement of TNT explosive more harmful to plants, study shows
Scientists reveal possible role of iron sulfides in creating life in terrestrial hot springs
Hormone therapy affects the metabolic health of transgender individuals
Survey of 12 European countries reveals the best and worst for smoke-free homes
First new treatment for asthma attacks in 50 years
Certain HRT tablets linked to increased heart disease and blood clot risk
Talking therapy and rehabilitation probably improve long covid symptoms, but effects modest
Ban medical research with links to the fossil fuel industry, say experts
Different menopausal hormone treatments pose different risks
Novel CAR T cell therapy obe-cel demonstrates high response rates in adult patients with advanced B-cell ALL
Clinical trial at Emory University reveals twice-yearly injection to be 96% effective in HIV prevention
Discovering the traits of extinct birds
Are health care disparities tied to worse outcomes for kids with MS?
For those with CTE, family history of mental illness tied to aggression in middle age
The sound of traffic increases stress and anxiety
Global food yields have grown steadily during last six decades
Children who grow up with pets or on farms may develop allergies at lower rates because their gut microbiome develops with more anaerobic commensals, per fecal analysis in small cohort study
North American Early Paleoindians almost 13,000 years ago used the bones of canids, felids, and hares to create needles in modern-day Wyoming, potentially to make the tailored fur garments which enabl
Higher levels of democracy and lower levels of corruption are associated with more doctors, independent of healthcare spending, per cross-sectional study of 134 countries
In major materials breakthrough, UVA team solves a nearly 200-year-old challenge in polymers
Wyoming research shows early North Americans made needles from fur-bearers
Preclinical tests show mRNA-based treatments effective for blinding condition
Velcro DNA helps build nanorobotic Meccano
Oceans emit sulfur and cool the climate more than previously thought
Nanorobot hand made of DNA grabs viruses for diagnostics and blocks cell entry
Rare, mysterious brain malformations in children linked to protein misfolding, study finds
Newly designed nanomaterial shows promise as antimicrobial agent
Scientists glue two proteins together, driving cancer cells to self-destruct
[Press-News.org] Study shows bariatric surgery provides superior long-term treatment for type 2 diabetes in patients with obesityTwelve-year data indicate greater weight loss and fewer diabetes medications after bariatric surgery compared to usual care