Welcome!

News Feed Item

Cleveland Clinic Study Shows Bariatric Surgery Provides Long-Term Control Of Type 2 Diabetes

Bariatric Surgery Patients Report Better Quality Of Life

CLEVELAND, March 31, 2014 /PRNewswire/ -- A study by Cleveland Clinic researchers shows bariatric surgery is a highly effective and durable treatment for type 2 diabetes in obese patients, enabling nearly all surgical patients to be free of insulin and many to be free of all diabetic medications three years after surgery.

(Logo:  http://photos.prnewswire.com/prnh/20140331/CL93179LOGO)

The STAMPEDE (Surgical Therapy And Medications Potentially Eradicate Diabetes Efficiently) trial was simultaneously published in The New England Journal of Medicine and presented today at the Annual Scientific Session of the American College of Cardiology in Washington, D.C. 

The study also shows that bariatric surgery patients experienced an improvement in quality of life and a reduction in the need for cardiovascular medications to control blood pressure and cholesterol compared to those receiving medical therapy. As a result, patients in the surgery groups used less cardiovascular and glucose-lowering medications – 5 to 10 percent were on insulin compared to 55 percent of the patients in the medical therapy group.

Obesity is the main trigger for type 2 diabetes. Given that an estimated one in every three adults in the United States is obese, health experts developed the term "diabesity" to talk about this epidemic. According to the American Diabetes Association, as many as one in three American adults will have diabetes in 2050 if present trends continue.

"We see patients whose lives are ravaged by diabetes. At the three-year mark, this study shows that bariatric surgery is more effective with persistent benefits noted up to 3 years for treating type 2 diabetes in moderate and severely obese patients when compared to medical therapy," said Sangeeta Kashyap, M.D., one of the lead investigators and an endocrinologist at Cleveland Clinic's Endocrinology & Metabolism Institute. "More than 90 percent of the patients who underwent bariatric surgery were able to lose 25 percent of their body weight and control their diabetes without the use of insulin and multiple diabetes drugs."

To date, the STAMPEDE study is the largest randomized trial with one of the longest follow-ups comparing medical therapy with bariatric surgery. The trial initially involved 150 overweight patients with poorly controlled diabetes. The patients were divided into three groups: 1) Fifty patients received intensive medical therapy only, including counseling and medications; 2) Fifty patients underwent Roux-en-Y gastric bypass surgery and received medical therapy; 3) Fifty patients underwent sleeve gastrectomy and received medical therapy.

Effectiveness was gauged by the percentage of patients who achieved blood sugar control, defined in this study as hemoglobin HbA1c level of less than or equal to 6.0 percent – a more aggressive target than the American Diabetes Association's guidelines. HbA1c is a standard laboratory test that reflects average blood sugar over three months.

At the three-year mark, more patients in the gastric bypass group (37.5 percent) achieved blood sugar control without the use of any diabetic medications compared with the other two groups -- 5 percent of the patients in the medical therapy group and 24.5 percent of the patients in the sleeve gastrectomy group. This correlates with a weight loss five to six times greater on average for patients who underwent bariatric surgery compared with those in the intensive medical therapy group.

"The three-year data confirm that bariatric surgery maintains its superiority over medical therapy for the treatment of type 2 diabetes in severely obese patients," said lead investigator Philip Schauer, M.D., Director of the Cleveland Clinic Bariatric and Metabolic Institute. "Moreover, data show that bariatric surgery is as effective in treating type 2 diabetes in patients with mild obesity. That's why Cleveland Clinic health insurance plan now covers bariatric surgery for its members with mild obesity and uncontrolled diabetes."

After three years, researchers were also able to evaluate the impact of diabetes and obesity on the patients' quality of life using a validated questionnaire (SF-36, Rand Corp.). Data show significant improvements in five of eight mental and physical domains for patients in the gastric bypass group and two of eight domains for the patients in the sleeve gastrectomy group. There was no improvement in the medical therapy group.

"We looked at quality of life, because ultimately it is all about helping our patients live a healthier, happier life," said Dr. Schauer. "When compared to sleeve gastrectomy and medical therapy, gastric bypass patients achieved greater weight loss, were on fewer medications, had a higher success rate in controlling their diabetes, and an improved quality of life."

In addition, new data looked at kidney function, measured by the amount of albumin in the urine and a marker of kidney damage due to diabetes. Albumin level was significantly lower in the gastric bypass group only.

Cleveland Clinic researchers have been at the forefront of research in this field. In addition to leading the STAMPEDE trial, pioneering Cleveland Clinic-led research includes a study showing for the first time that bariatric surgery can markedly improve type 1 diabetes, with some patients reducing their insulin intake by more than 60 percent. The results were published in the March 2014 issue of Diabetes Care.

A substudy of STAMPEDE, published in Diabetes Care in 2013, found that gastric bypass surgery reverses diabetes by uniquely restoring pancreatic function in moderately obese patients with uncontrolled type 2 diabetes.

Further research is needed to continue to advance the study of bariatric surgery as a treatment option for patients with diabetes.

More information on the STAMPEDE clinical trial can be found at clevelandclinic.org/stampede.

The STAMPEDE study was funded by Ethicon, part of the Johnson & Johnson family of companies, through its Metabolic Applied Research Strategy (MARS) program. The NIH grant number is R01 DK089547.

Dr. Schauer is a paid consultant for Ethicon.

About Cleveland Clinic

Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S.News & World Report consistently names Cleveland Clinic as one of the nation's best hospitals in its annual "America's Best Hospitals" survey. More than 3,000 full-time salaried physicians and researchers and 11,000 nurses represent 120 medical specialties and subspecialties. The Cleveland Clinic health system includes a main campus near downtown Cleveland, eight community hospitals, more than 75 Northern Ohio outpatient locations, including 16 full-service Family Health Centers, Cleveland Clinic Florida, the Lou Ruvo Center for Brain Health in Las Vegas, Cleveland Clinic Canada, and, currently under construction, Cleveland Clinic Abu Dhabi. In 2012, there were 5.1 million outpatient visits throughout the Cleveland Clinic health system and 157,000 hospital admissions. Patients came for treatment from every state and from more than 130 countries. Visit us at www.clevelandclinic.org.  Follow us at www.twitter.com/ClevelandClinic.

Editor's Note: Cleveland Clinic News Service is available to provide broadcast-quality interviews and B-roll upon request.

Contact:

Andrea Pacetti, 216-316-3040, [email protected]
Caroline Auger, 216.636.5874, [email protected]

SOURCE Cleveland Clinic

More Stories By PR Newswire

Copyright © 2007 PR Newswire. All rights reserved. Republication or redistribution of PRNewswire content is expressly prohibited without the prior written consent of PRNewswire. PRNewswire shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.

Latest Stories
The dynamic nature of the cloud means that change is a constant when it comes to modern cloud-based infrastructure. Delivering modern applications to end users, therefore, is a constantly shifting challenge. Delivery automation helps IT Ops teams ensure that apps are providing an optimal end user experience over hybrid-cloud and multi-cloud environments, no matter what the current state of the infrastructure is. To employ a delivery automation strategy that reflects your business rules, making r...
Modern software design has fundamentally changed how we manage applications, causing many to turn to containers as the new virtual machine for resource management. As container adoption grows beyond stateless applications to stateful workloads, the need for persistent storage is foundational - something customers routinely cite as a top pain point. In his session at @DevOpsSummit at 21st Cloud Expo, Bill Borsari, Head of Systems Engineering at Datera, explored how organizations can reap the bene...
Kubernetes is an open source system for automating deployment, scaling, and management of containerized applications. Kubernetes was originally built by Google, leveraging years of experience with managing container workloads, and is now a Cloud Native Compute Foundation (CNCF) project. Kubernetes has been widely adopted by the community, supported on all major public and private cloud providers, and is gaining rapid adoption in enterprises. However, Kubernetes may seem intimidating and complex ...
In a recent survey, Sumo Logic surveyed 1,500 customers who employ cloud services such as Amazon Web Services (AWS), Microsoft Azure, and Google Cloud Platform (GCP). According to the survey, a quarter of the respondents have already deployed Docker containers and nearly as many (23 percent) are employing the AWS Lambda serverless computing framework. It’s clear: serverless is here to stay. The adoption does come with some needed changes, within both application development and operations. Tha...
In his session at 21st Cloud Expo, Michael Burley, a Senior Business Development Executive in IT Services at NetApp, described how NetApp designed a three-year program of work to migrate 25PB of a major telco's enterprise data to a new STaaS platform, and then secured a long-term contract to manage and operate the platform. This significant program blended the best of NetApp’s solutions and services capabilities to enable this telco’s successful adoption of private cloud storage and launching ...
In his general session at 21st Cloud Expo, Greg Dumas, Calligo’s Vice President and G.M. of US operations, discussed the new Global Data Protection Regulation and how Calligo can help business stay compliant in digitally globalized world. Greg Dumas is Calligo's Vice President and G.M. of US operations. Calligo is an established service provider that provides an innovative platform for trusted cloud solutions. Calligo’s customers are typically most concerned about GDPR compliance, application p...
The past few years have brought a sea change in the way applications are architected, developed, and consumed—increasing both the complexity of testing and the business impact of software failures. How can software testing professionals keep pace with modern application delivery, given the trends that impact both architectures (cloud, microservices, and APIs) and processes (DevOps, agile, and continuous delivery)? This is where continuous testing comes in. D
The 22nd International Cloud Expo | 1st DXWorld Expo has announced that its Call for Papers is open. Cloud Expo | DXWorld Expo, to be held June 5-7, 2018, at the Javits Center in New York, NY, brings together Cloud Computing, Digital Transformation, Big Data, Internet of Things, DevOps, Machine Learning and WebRTC to one location. With cloud computing driving a higher percentage of enterprise IT budgets every year, it becomes increasingly important to plant your flag in this fast-expanding busin...
Smart cities have the potential to change our lives at so many levels for citizens: less pollution, reduced parking obstacles, better health, education and more energy savings. Real-time data streaming and the Internet of Things (IoT) possess the power to turn this vision into a reality. However, most organizations today are building their data infrastructure to focus solely on addressing immediate business needs vs. a platform capable of quickly adapting emerging technologies to address future ...
SYS-CON Events announced today that Synametrics Technologies will exhibit at SYS-CON's 22nd International Cloud Expo®, which will take place on June 5-7, 2018, at the Javits Center in New York, NY. Synametrics Technologies is a privately held company based in Plainsboro, New Jersey that has been providing solutions for the developer community since 1997. Based on the success of its initial product offerings such as WinSQL, Xeams, SynaMan and Syncrify, Synametrics continues to create and hone in...
You know you need the cloud, but you’re hesitant to simply dump everything at Amazon since you know that not all workloads are suitable for cloud. You know that you want the kind of ease of use and scalability that you get with public cloud, but your applications are architected in a way that makes the public cloud a non-starter. You’re looking at private cloud solutions based on hyperconverged infrastructure, but you’re concerned with the limits inherent in those technologies.
No hype cycles or predictions of a gazillion things here. IoT is here. You get it. You know your business and have great ideas for a business transformation strategy. What comes next? Time to make it happen. In his session at @ThingsExpo, Jay Mason, an Associate Partner of Analytics, IoT & Cybersecurity at M&S Consulting, presented a step-by-step plan to develop your technology implementation strategy. He also discussed the evaluation of communication standards and IoT messaging protocols, data...
Nordstrom is transforming the way that they do business and the cloud is the key to enabling speed and hyper personalized customer experiences. In his session at 21st Cloud Expo, Ken Schow, VP of Engineering at Nordstrom, discussed some of the key learnings and common pitfalls of large enterprises moving to the cloud. This includes strategies around choosing a cloud provider(s), architecture, and lessons learned. In addition, he covered some of the best practices for structured team migration an...
With tough new regulations coming to Europe on data privacy in May 2018, Calligo will explain why in reality the effect is global and transforms how you consider critical data. EU GDPR fundamentally rewrites the rules for cloud, Big Data and IoT. In his session at 21st Cloud Expo, Adam Ryan, Vice President and General Manager EMEA at Calligo, examined the regulations and provided insight on how it affects technology, challenges the established rules and will usher in new levels of diligence arou...
Most technology leaders, contemporary and from the hardware era, are reshaping their businesses to do software. They hope to capture value from emerging technologies such as IoT, SDN, and AI. Ultimately, irrespective of the vertical, it is about deriving value from independent software applications participating in an ecosystem as one comprehensive solution. In his session at @ThingsExpo, Kausik Sridhar, founder and CTO of Pulzze Systems, discussed how given the magnitude of today's application ...