Is Bariatric Surgery Better Than Lifestyle to Prevent Diabetes?

A Cleveland Clinic study is looking at long-term effects of bariatric surgery.

Tackling type 2 diabetes usually involves a combination of medications, such as metformin, as well as a careful diet, regular exercise, and other healthy lifestyle choices. In recent years, many obese individuals with type 2 diabetes have seen their symptoms become well controlled, and occasionally disappear after surgery.

In a new study, led by Cleveland Clinic researchers, physicians at several hospitals around the nation are going to compare these two approaches. The study is called the Alliance of Randomized Trials of Medicine versus Metabolic Surgery in Type 2 Diabetes (ARMMS-T2D).

“The primary goal of the ARMMS-T2D clinical trial is to evaluate the effectiveness of bariatric surgery compared to medical therapy to treat type 2 diabetes over a longer period of time. We will also identify clinical predicators of diabetes remission and relapse,” says John Kirwan, PhD, principal investigator and director of the Metabolic Translational Research Center at Cleveland Clinic Lerner Research Institute.

Bariatric surgery isn’t for everyone, and it does require a disciplined approach to diet and other lifestyle choices. But there has been some encouraging evidence that for certain obese people, weight-loss surgery may be the key to overcoming the difficult-to-manage type 2 diabetes.

“Despite advances in medical treatment, type 2 diabetes remains a major cause of morbidity and mortality in the U.S.,” says Sangeeta Kashyap, MD, an endocrinologist and co-investigator with Cleveland Clinic’s Endocrinology and Metabolic Institute. “Metabolic surgery is a promising new option that may reduce complications of type 2 diabetes. ARMMS-T2D will provide physicians and patients critical long-term results of surgery compared to medical treatment to better guide therapy.”