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Surgery gives long-term help for obese diabetics
The surgery groups also shed more pounds — 25 percent and 21 percent of their body weight versus 4 percent for the medication group.
Some cholesterol and other heart risk factors also improved in the surgery groups and they required fewer medicines for these than at the start.
Doctors don't know how surgery produces these benefits, but food makes the gut produce hormones to spur insulin, and trimming away part of it affects many hormones and metabolism.
Four patients needed a second surgery within a year but none did after that. Out-of-control diabetes has complications, too — many patients lose limbs or wind up on dialysis when their kidneys fail, and some need transplants.
An obesity surgery equipment company sponsored the study, and some of the researchers are paid consultants; the federal government also gave grant support.
Dr. Robert Ratner, chief scientific and medical officer for the American Diabetes Association, said he was "very encouraged" that so many stayed in the study, and said it will remain important to follow participants longer, because many people who have weight-loss surgery regain substantial weight down the road.
"Any way you lose weight is beneficial" for curbing diabetes, he said, but "we need to be concerned about the cost and complications" of treatments. Diets cost less and have fewer side effects, Ratner said.
One other common type of obesity surgery, stomach banding, was not part of this study. Its use has declined in recent years as other types of surgery have shown long-term benefits for keeping weight off.
Surgery explainer: http://1.usa.gov/1gHoOX4
Weight loss info: http://1.usa.gov/1gTBk6Q
Diabetes info: http://www.diabetes.org
Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP