http://www.nbcnews.com/health/diabetes/obesity-surgery-good-way-treat-diabetes-groups-agree-n579531
Unfortunately, the article doesn't say WHICH surgery.
Going to the source: http://care.diabetesjournals.org/
http://care.diabetesjournals.org/content/39/6/857 - (Overview) "Metabolic Surgery for Type 2 Diabetes: Changing the Landscape of Diabetes Care"
http://care.diabetesjournals.org/content/39/6/861 - "Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations" Francesco Rubino et al.
Unfortunately, the DS is mentioned with reference to some of the POOR outcomes of the published literature:
The other good news was recommending metabolic surgery for diabetics with poor control down to a BMI of 30.
Unfortunately, the article doesn't say WHICH surgery.
Going to the source: http://care.diabetesjournals.org/
http://care.diabetesjournals.org/content/39/6/857 - (Overview) "Metabolic Surgery for Type 2 Diabetes: Changing the Landscape of Diabetes Care"
http://care.diabetesjournals.org/content/39/6/861 - "Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations" Francesco Rubino et al.
Unfortunately, the DS is mentioned with reference to some of the POOR outcomes of the published literature:
"There are, however, still complications of surgery that may require reoperations and rehospitalizations. A recent multicenter study showed early reoperation and readmission rates after laparoscopic operations of 2.5% and 5.1% for RYGB, versus 0.6% and 2.0% for laparoscopic adjustable gastric banding (LAGB), versus 0.6% and 5.5% for vertical sleeve gastrectomy (VSG), after a median 3-year follow-up (76). Long-term studies (>5 years) demonstrate low rates of reoperation after most bariatric/metabolic procedures except LAGB, which is associated with removal or revision rates of >20% over 5–10 years (72,77–79). Biliopancreatic diversion (BPD), classic type or duodenal switch (BPD-DS), is the most complex procedure, requires longer operative time, and is associated with the highest perioperative mortality and morbidity rates (80). Compared with RYGB, BPD results in more surgical complications and greater incidence of GI side effects (81), as well as nutritional deficiencies (20) (LoE IB)."
*****
"It is too early to establish a gold standard operation for metabolic surgery because of the paucity of RCTs comparing surgical procedures head-to-head. However, available RCTs and nonrandomized studies specifically designed to compare different procedures against medical/lifestyle interventions or other operations in patients with T2D show a gradient of efficacy among the four accepted surgical approaches for weight loss and diabetes remission, as follows: BPD>RYGB>VSG>LAGB. The opposite gradient exists for comparative safety of these operations (10–25,72,76–79,101–104). Evidence from these studies can be summarized as follows:
Sigh.*****
"It is too early to establish a gold standard operation for metabolic surgery because of the paucity of RCTs comparing surgical procedures head-to-head. However, available RCTs and nonrandomized studies specifically designed to compare different procedures against medical/lifestyle interventions or other operations in patients with T2D show a gradient of efficacy among the four accepted surgical approaches for weight loss and diabetes remission, as follows: BPD>RYGB>VSG>LAGB. The opposite gradient exists for comparative safety of these operations (10–25,72,76–79,101–104). Evidence from these studies can be summarized as follows:
- RYGB versus BPD: BPD promotes greater T2D remission but more metabolic complications compared with RYGB (LoE IB).
- RYGB versus LAGB: RYGB achieves greater diabetes remission compared with LAGB (LoE IA). RYGB is associated with higher risk of early postoperative complications but lower risk of long-term reoperations (LoE IIA).
- RYGB versus VSG: Compared with VSG, RYGB promotes higher diabetes remission rates (LoE IA), better lipid control (LoE IA), similar risk of reoperation (LoE IA), better quality of life (LoE IB), and higher incidence of postoperative complications (LoE IA)."
The other good news was recommending metabolic surgery for diabetics with poor control down to a BMI of 30.
