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The study followed approximately 20,000 seriously obese patients with type 2 diabetes. People who underwent weight loss surgery were 40% less likely to develop a heart attack or stroke within five years following surgery, compared to those who were receiving usual care with antidiabetic drugs or insulin.
For every 1,000 patients in the study who underwent surgery, there were approximately 20 heart attacks or strokes, compared with 40 such events per 1,000 people who received regular care.
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 that obesity surgery can reverse and even prevent diabetes. Taken together, this means that doctors should discuss weight loss surgery more often, said Dr. David Arterburn, co-author of the study, of the Kaiser Permanente Washington Institute for Health Research in Seattle.
Doctors usually mention insulin and pills, "but it's not always mentioned that weight loss surgery is another available treatment option," said Arterburn.
The researchers analyzed data from four US health care systems: Minnesota HealthPartners and Kaiser Permanente in Washington State, Northern California and Southern California. The findings were published Tuesday in the Journal of the American Medical Association.
The study can not prove the cause and effect because the patients were not randomly assigned to a surgical procedure. Researchers have tried to match patients by gender, age, blood sugar, and other factors. But other factors not taken into account could have contributed to the best results of operated patients.
All people participating in the study had a BMI, or body mass index, of at least 35. For example, a person measuring 5 feet 8 inches and weighing 230 pounds had a BMI of 35.
Of the more than 5,300 people who have undergone surgery, most have undergone gastric bypass surgery, the most common type of stomach contraction operation. Some had gastric sleeve or gastric band procedures. The others, nearly 15,000 people, benefited from the usual care.
Obesity surgery can cost between $ 20,000 and $ 25,000. Insurers are covering it more and more, but some are imposing strict limits.
New findings suggest that insurance coverage should be extended to the right patients, Dr. Sayeed Ikramuddin of the University of Minnesota wrote in an editorial.
It is thought that surgery can help by affecting hormones, intestinal bacteria and other substances that affect the way the body handles insulin and blood sugar. Weight loss without surgery also helps, but is difficult for many people to achieve.
Most weight loss operations are done today through small incisions. The dangers are similar to those of other surgeries, including a low risk of life-threatening complications, and some people have to undergo surgery again.
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