JAMA Logo Bariatric surgery was previously claimed as an effective treatment for getting rid of obesity among teens. It also seems to be effective for diabetes patients, or at least the following study suggests so. Scientists believe that bariatric surgery is linked with decreased use of medications and lower health care costs among patients with type 2 diabetes.

Patients subjected to bariatric surgery report long-term weight loss, improved lifestyle and decreased risk of death. The study was conducted on 2,235 U.S. adults with an average age of 48.4 years. These study participants were suffering from type 2 diabetes and had gone through bariatric surgery during a four-year period, from 2002 to 2005. Claims data for measuring the use of diabetes medications before and after surgery. Also the health care costs of per year were taken into consideration by Martin A. Makary, M.D., M.P.H., and colleagues at the Johns Hopkins Bloomberg School of Public Health and The Johns Hopkins University School of Medicine, Baltimore.

Investigators explain, “The rapidly growing epidemics of obesity and diabetes threaten to overburden the world’s health care systems. From an epidemiological standpoint, once these diseases develop they are rarely reversed. Dietary, pharmaceutical and behavior treatments for obesity are associated with high failure rates, and medical management of diabetes is also often unsuccessful. Despite many efforts to improve the control of glucose levels in diabetes, including clinical guidelines and patient and provider education, less than half of all patients with type 2 diabetes mellitus achieve the American Diabetes Association recommendation of a hemoglobin A1C level of less than 7 percent.”

It was revealed that a total of 1,918 patients forming 85.8 percent were on at least one diabetes medication before surgery, with an average of 4.4 medications per patient. After six months of the surgery, 1,669 from 2,235 patients representing 74.7 percent had stopped consuming their diabetes medications. 1,847 patients had data available one year after surgery. From these patients 1,489 presenting 80.6 percent had halted the intake of medications after two years. Around 906 of 1,072 forming 84.5 percent had also stopped consuming medications. Experts observed this decline in all classes of diabetes medications.

Authors quote, “We observed that independence from diabetes medication was almost immediate within the initial months after surgery and did not correlate with the gradual weight loss expected. This supports the theory that the resolution of diabetes is not due to weight loss alone but is also mediated by gastric hormones, with the three most implicated being peptide YY, glucagonlike peptide and pancreatic polypeptide. As a known mediator of insulin regulation, glucagonlike peptide levels have been noted to increase immediately after bariatric surgery and may explain why surgeons have noted complete resolution of diabetes in some cases within days after surgery.”

It was revealed that that the health care cost on an average was $6,376 annually in the two years before surgery. $29,959 was ascertained as the median cost of the surgery and hospitalization. On inclusion of the procedure, total annual health care costs elevated by 9.7 percent that is $616 each year. However, in the next year a decline of 34.2 percent was registered, so the cost was $2,179. A year after the cost again appeared to reduce by 70.5 percent and the cost spent was $4,498.

Investigators cautioned that before employing the bariatric surgery, eligible obese patients should be made aware about the risks and benefits of bariatric surgery as compared to non-surgical health management. This type of surgery can be seemingly utilized as a treatment in obese patients with type 2 diabetes. It was suggested that health insurers, private and public, should pay for bariatric surgery for appropriate candidates due to its annualized cost savings in addition to the benefit to health.

The study is published in the August issue of Archives of Surgery, one of the JAMA/Archives journals.