"Two years is a relatively short outcome," acknowledged Rubino. "And this was a small study. But the effect of surgery was almost immediate among the surgical patients. And I think it's clear that while patients getting medicinal therapy did improve somewhat, the chance for patients to achieve robust improvement in diabetes is much greater for those who have surgery than those who are treated with standard medications."
Dr. Loren Wissner Greene, an endocrinologist at NYU Langone Medical Center in New York City, expressed little surprise at the findings.
"That's been widely reported," she noted. "Of course, how one fares does depend on the individual. One can eat around any procedure, meaning that if a patient drinks high-caloric liquids following surgery, and manages not to lose weight, that can affect the result," Greene explained.
"At the same time, there is very good evidence for diabetic remission after surgery, particularly for diverting procedures, where there could be a beneficial impact on gut hormones like leptin and ghrelin," Greene added.
"There are some risks, however," she cautioned. "And people who have bad presurgical problems -- those with high blood pressure or obesity-related sleep apnea -- might be limited in terms of the type of obesity surgery they can get. But for those who can do it, it may really be the better way to go. And in the end, though surgery is extremely expensive, it might even be cheaper than having to take expensive diabetic medications for years to come."
For more on weight-loss surgery, visit the U.S. National Library of Medicine.
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