A N NA L S O F M E D I C I N E A N D S U RG E RY
Correspondence Future Directions for Bariatric Surgery in Type 2 Diabetes Eric Edison BA (Cantab)a, Christian F. Camm BA (Cantab)b, Riaz Agha BSc (Hons), MBBS, MRCSc a
UCL Medical School, University College London, Gower Street, London, WC1E 6BT, United Kingdom; bNational Institute for Health and Clinical Excellence Scholar, London, Department of Plastic Surgery, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, West Sussex, RH19 3DZ, United Kingdom; cNew College, Oxford, OX1 3BN, United Kingdom Correspondence to: Eric Edison, UCL Medical School, University College London, Gower Street, London WC1E 6BT, United Kingdom Tel.: 07939436729; Email: [email protected]
Article history Received: 26 June 2012 Accepted: 28 July 2012 Available online: 10 August 2012
Provenance and Peer Review In house, editorial review
Keywords Bariatric surgery Type 2 diabetes Obesity
Two randomised controlled trials reported earlier this year have demonstrated convincingly that bariatric surgery is effective in controlling hyperglycaemia in patients with type 2 diabetes. However, there is still a long way to go to determine if and how surgery should be used to treat diabetes. Mingrone et al.1 randomised 60 patients to conventional medical treatment, gastric bypass or biliopancreatic diversion at the Day Hospital of Metabolic Diseases and Diabetology of the Catholic University in Rome. Schauer et al.2 randomised 150 patients to optimal medical therapy, gastric bypass, or sleeve gastrectomy at the Cleveland Clinic, USA. Though they had slightly different end points, the results were dramatic in both. Schauer found that surgery caused a drop of glycated haemoglobin of up to 3% that was maintained at one year. In comparison, medical treatment was roughly half as effective, and this effect began to attenuate from 6 months despite the addition of more hypoglycaemic agents. Mingrone et al. defined diabetic remission at two years as a fasting plasma glucose of
Correspondence Future Directions for Bariatric Surgery in Type 2 Diabetes Eric Edison BA (Cantab)a, Christian F. Camm BA (Cantab)b, Riaz Agha BSc (Hons), MBBS, MRCSc a
UCL Medical School, University College London, Gower Street, London, WC1E 6BT, United Kingdom; bNational Institute for Health and Clinical Excellence Scholar, London, Department of Plastic Surgery, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, West Sussex, RH19 3DZ, United Kingdom; cNew College, Oxford, OX1 3BN, United Kingdom Correspondence to: Eric Edison, UCL Medical School, University College London, Gower Street, London WC1E 6BT, United Kingdom Tel.: 07939436729; Email: [email protected]
Article history Received: 26 June 2012 Accepted: 28 July 2012 Available online: 10 August 2012
Provenance and Peer Review In house, editorial review
Keywords Bariatric surgery Type 2 diabetes Obesity
Two randomised controlled trials reported earlier this year have demonstrated convincingly that bariatric surgery is effective in controlling hyperglycaemia in patients with type 2 diabetes. However, there is still a long way to go to determine if and how surgery should be used to treat diabetes. Mingrone et al.1 randomised 60 patients to conventional medical treatment, gastric bypass or biliopancreatic diversion at the Day Hospital of Metabolic Diseases and Diabetology of the Catholic University in Rome. Schauer et al.2 randomised 150 patients to optimal medical therapy, gastric bypass, or sleeve gastrectomy at the Cleveland Clinic, USA. Though they had slightly different end points, the results were dramatic in both. Schauer found that surgery caused a drop of glycated haemoglobin of up to 3% that was maintained at one year. In comparison, medical treatment was roughly half as effective, and this effect began to attenuate from 6 months despite the addition of more hypoglycaemic agents. Mingrone et al. defined diabetic remission at two years as a fasting plasma glucose of
