By ASSOCIATED PRESS
OCTOBER 16, 2018
SEATTLE
— Obesity surgery may dramatically lower the danger of heart attacks and
strokes in patients with diabetes, new research suggests, reinforcing evidence
that benefits extend beyond weight loss.
The study
tracked about 20,000 severely obese patients with Type 2 diabetes. Those who
had weight loss surgery had a 40 percent lower chance of developing a heart
attack or stroke in the five years following surgery compared to those who got
usual care with diabetes medicines or insulin.
For every
1,000 patients in the study who had surgery there were roughly 20 heart attacks
or strokes compared to 40 such events per 1,000 who got regular care.
RADIUS HEALTH, INC.
More than
30 million Americans have diabetes, mostly Type 2 where the body loses the
ability to produce or use insulin to turn food into energy.
Other
research has shown obesity surgery can reverse and even prevent diabetes. Taken
together, it means doctors should discuss weight loss surgery more often, said
study co-author Dr. David Arterburn of Kaiser Permanente Washington Health
Research Institute in Seattle.
Doctors
usually mention insulin and pills, “but it’s not always brought up that weight
loss surgery is another available treatment option,” Arterburn said.
Researchers
analyzed records from four U.S. health care systems: HealthPartners in Minnesota
and Kaiser Permanente in Washington state, Northern California and Southern
California. Results were published Tuesday in the Journal of the American
Medical Association.
The study
can’t prove cause and effect because patients weren’t randomly assigned to get
surgery. The researchers tried to match patients for gender, age, blood sugar
levels and other factors. But other things they didn’t account for could have
contributed to the surgery patients’ better results.
Everyone
in the study had a BMI, or body mass index, of at least 35. For instance,
someone who is 5-foot-8-inches and weighs 230 pounds has a BMI of 35.
Of the
more than 5,300 who had surgery, most had gastric bypass, the most common type
of stomach-shrinking operation. Some had gastric sleeve or gastric band
procedures. The rest, nearly 15,000 people, had usual care.
Obesity
surgery can cost $20,000 to $25,000. Insurers are increasingly covering it, but
some impose strict limits.
The new
findings suggest insurance coverage should be expanded for the right patients,
Dr. Sayeed Ikramuddin of the University of Minnesota wrote in an accompanying
editorial.
Surgery
is thought to help by affecting hormones, gut bacteria and other substances
that affect how the body handles insulin and blood sugar. Weight loss without
surgery also helps, but is difficult for many people to achieve.
Most
weight loss surgery today is done through small incisions. The dangers are
similar to other surgeries, including a small chance of life-threatening
complications, and some people need to have their surgeries repeated.
— Carla K. Johnson
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