new_england_journal300As reported on March 26, 2012, in the New England Journal of Medicine, STAMPEDE, a recently released study, concluded that bariatric surgery resulted in better glucose control than medical therapy in severely obese patients with Type 2 diabetes.

STAMPEDE (Surgical Treatment and Medications Potentially Eradicate Diabetes Efficiently) included 60 patients between the ages of 30 and 60 years with a body mass index (BMI) of 35 or more and a history of at least five years of diabetes. Study participants were randomly assigned to receive conventional medical therapy or undergo either gastric bypass or biliopancreatic diversion.

The results were significant. At two years, diabetes remission had occurred in no patients in the medical therapy group versus 75 percent in the gastric-bypass group and 95 percent in the biliopancreatic diversion group. The results also showed that remission was independent of weight loss, suggesting that the positive outcomes are a result of metabolic changes achieved through surgery.

This line of thinking is supported by the International Diabetes Federation (IDF), an umbrella organization of more than 200 national diabetes associations in more than 160 countries. In late 2011 they issued a position statement supporting bariatric surgery to treat Type 2 diabetes in obese patients. The IDF statement was generated as a result of key thought leaders and organizations collaborating over the past five years. It was written by 20 leading experts in diabetes and bariatric surgery.

We are seeing positive changes in the conversation about bariatric surgery. STAMPEDE supports the new way of thinking– viewing it as metabolic surgery, a therapeutic intervention that can improve or resolve many metabolic conditions. In addition to addressing Type 2 diabetes, bariatric surgery can improve or resolve heart disease, hypertension, sleep apnea and high cholesterol.

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