Experts to review latest research on bariatric surgery at International summit

September 09, 2017

Currently, a clinical trial is under way at NewYork-Presbyterian/Weill Cornell to test surgery as a means of controlling diabetes in patients who are overweight or mildly obese -- i.e., with a BMI between 26 and 34.

"Surgery is not right for every patient with Type 2 diabetes. The very success of the surgery in improving or even resolving the disease is what makes the need for new guidelines so urgent," says Dr. Lebovitz.

Cardiovascular Risk and Longevity

The connection between diabetes and heart disease is so strong that some consider diabetes a cardiovascular disease on its own. For a diabetes treatment to be successful, then, it must go beyond blood sugar regulation alone. "It must bring patients' physiology into long-term balance so as to significantly lower their risk of cardiovascular disease, the leading cause of death in the United States and worldwide," says Dr. Rubino.

New data on the long-term reduction of cardiovascular risk and overall survival after metabolic surgery will be presented at the Congress. In one presentation, Dr. Lars Sj?¶str?¶m, professor at the Institute of Medicine in G?¶teborg, Sweden, will provide an update from the Swedish Obesity Study (SOS) after 20 years since its inception. The longest study of its kind, SOS has compared more than 2,010 bariatric surgeries for weight loss to a similar number of patients undergoing conservative (lifestyle or medical) treatments. The results presented at the Congress will show that bariatric surgery outperformed non-surgical approaches with respect to long-term weight loss, control of high blood sugar, decrease in cardiovascular risk, and overall survival.

"The next step will be to design multicenter, randomized, controlled trials comparing patients grouped by body weight who are receiving gastric bypass for Type 2 diabetes with those being treated non-surgically," says Dr. David Cummings, a leading endocrinologist and professor of medicine at the University of Washington in Seattle. "We have been working with the NIH to design a study that will generate the volume and quality of data we need to move that agenda forward."

Cost-Effectiveness Research

Another focus of research to be presented at the Congress is the issue of cost effectiveness. Dr. Zimmet and colleagues, including Catherine Keating, from Deakin University in Melbourne, Australia; Dr. Frank Lefevre, from Northwestern University's Feinberg School of Medicine; and Dr. Sean Sullivan, from the University of Washington, will compare the cost of the surgery -- presumably a one-time intervention with periodic follow-up -- with the lifetime costs associated with medical management of the disease and its complications affecting the eyes, heart, kidneys and extremities. Long-term costs include outpatient care, prescription medications and diabetes-related hospitalizations and surgeries, including amputations.

Source: NewYork-Presbyterian Hospital