Are you considering bariatric surgery to cure your diabetes? Results of a study reported in the New England Journal of Medicine have received quite a bit of media attention and may encourage people with diabetes to ask about bariatric surgery. There are 27 million people with diabetes type 2. Diabetes type 2 is associated with macrovascular disease (heart attacks, strokes and non-traumatic amputations) as well as microvascular disease (kidney disease, and blindness). The cost of treating Diabetes type 2 as well as these complications has created a public health problem affecting all Americans. 150 people with severe type 2 diabetes, were randomized to have either medical treatment alone (50) or medical treatment with either a gastric bypass (50) or gastric sleeve (50). No patients in this study had the lap band. All surgery was done by the same surgeon at the Cleveland Clinic. The patients in the surgical groups had significant improvement within the first three months leading to the conclusion that surgery had a beneficial effect from altering gut hormones as well as from the weight loss. At the end of the year the surgical group had an average drop in A1C of 2.9 and the medical group had a decrease in A1C by 1.6. These patients will need further followup to see the long term benefit. The surgery was done in one clinic by one surgeon and the results may vary with the center performing the surgery. This study is related to type 2 diabetes and is not applicable to Diabetes type 1. If you think this is an appropriate option for you, please discuss the risk and benefit of having surgery with your health care provider. In the meantime, do everything you can to maximize the benefits you are receiving from medical therapy. We welcome your comments. Have you had surgery, and was it beneficial? Are you considering surgery, and if so please share your thoughts.
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