The data collected suggests that there is evidence to support the working hypothesis that Bariatric surgery may be more effective in maintaining normal glycemic control in patients with T2DM compared to standard therapy.
Bariatric Surgery versus Standard Medical Therapy A randomized controlled trial carried out by Ikramuddin et al. (2013) compared conventional standard therapy with lifestyle modification to a single type of Bariatric operation (Roux-en-Y gastric procedure [RYGB]) and measured the effect on glucose control in patients with T2DM. The key outcome and measure of this study with respect to glycemic control was to attain a target HbA1c level below 7% (Ikramuddin et al., 2013). At baseline, these patients had…show more content… Obese Patients with Type 2 Diabetes Mellitus In accordance with the previous findings, one particular trial (Cohen et al., 2012) specifically examined the long term effect of Roux-en-Y gastric bypass surgery on patients with T2DM with Class I obesity (BMI between 30-35 kg/m2). The study followed 66 patients who underwent this procedure for a period of six years and found that 88% of the participants were able to achieve euglycemia without the use of standard diabetic therapy and 11 % had an improvement in glycemic control in comparison to standard therapy (Cohen et al., 2012). Interestingly, the study (Cohen et al., 2012) points out that there was an improvement in Beta cell function in the pancrease due to an increase in C-peptide response to glucose after the procedure.
Likewise, the study conducted by Ikramudden et al. (2013) which evaluated the same RYGB procedure, found an improvement of glycemic control in T2DM patients who had a BMI between 30.0 to 39.9. The ‘Swedish Obesity Study’ by (Carlsson et al., 2012) examined the effects of Bariatric surgery (1658 patients) vs standard therapy (1771 patients) in the prevention of T2DM in Swedish patients with a BMI>34 kg/m2. The study (Carlsson et al., 2012) found that metabolic surgery was much more effective than conventional therapy where only a 110 subjects in the procedure group compared to 392 subjects in the