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Obesity surgery 'cures' diabetes

Obesity surgery can lead to long-term remission of type 2 diabetes in almost four out of five cases suggests US resear

The study randomised 60 obese patients with diabetes to receive weight loss advice with a focus on lifestyle changes or laproscopic adjustable gastric banding. Both also received conventional diabetes care.

After two years, remission of diabetes was seen in 76% of those in the surgery group compared with 15% in the lifestyle advice group.

The surgical group achieved an average 20.7% body weight loss at two years, compared with 1.7% among the conventional-therapy group, representing a loss of 62.5% of excess weight (using BMI of 25 as ideal weight) in the surgical group compared with 4.3% in the conventional-therapy group. There were no serious complications in either group.

'An important finding of this study is that degree of weight loss, not the method, appears to be the major driver of glycemic improvement and diabetes remission in obese participants. This has important implications, as it suggests that intensive weight-loss therapy may be a more effective first step in the management of diabetes than simple lifestyle change. This study shows that few participants achieved remission with a body weight loss of less than 10 percent, a level expected to produce important health benefits,' the researchers add.

Larger trials are needed but this is the strongest evidence to date that surgery can ‘cure' diabetes they add.

JAMA 2008;299(3):316-323.

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