(January 22, 2008 - Insidermedicine) Bariatric surgery is more effective at helping obese patients with type 2 diabetes lose weight and attain diabetes remission than conventional weight loss and diabetes control approaches, according to research published in the Journal of the American Medical Association.

According to the Society of American Gastrointestinal Endoscopic Surgeons, bariatric surgery should be considered for patients who:

•    have a body mass index (BMI) equal to or greater than 40 kg/m2, or

•    have a BMI equal to or greater than 35 kg/m2 and significant comorbidities, and

•    can show that dietary attempts at weight control have been ineffective

Researchers from Monash University randomized 60 individuals with type 2 diabetes and a BMI over 30 but under 40 to receive gastric banding surgery or conventional diabetes therapy focusing on lifestyle management.

After two years, the diabetes remission rate was 76% in the surgery group, compared with only 15% in the standard treatment group. The surgical group also had a fourfold greater reduction in hemoglobin (Hb) A1C than the conventional therapy group, and achieved a 62.5% loss of excess weight, compared with only a 4.3% loss in the conventional group. While both percentage of weight loss and HbA1C level at baseline independently predicted remission rates, percentage of weight loss accounted for most of the variance.

Today's research supports that a weight loss of at least 10% is necessary to achieve significant health benefits, suggesting that aggressive weight loss therapy is an important step in managing obese patients with type 2 diabetes.

For Insidermedicine in Depth, I'm Dr. Susan Sharma.