Harvard Heart Letter

Weight-loss surgery for uncontrolled diabetes

For people with obesity and uncontrolled diabetes, weight-loss surgery can bring diabetes under control far more effectively than medications, a New England Journal of Medicine study has shown.

The study included 150 people with an average body mass index (BMI) of 36. Obesity is defined as a BMI of 30 or more. Their average HbA1c level (a long-term measurement of blood sugar) was 9.3%. Normal levels range between 4% and 5.6%.

People in the study received either intensive medical therapy for diabetes or weight-loss surgery—either a gastric bypass or a sleeve gastrectomy. A gastric bypass creates a small pouch that bypasses most of the stomach and is then reattached to the small intestine. The sleeve procedure removes about 75% of the stomach, leaving just a vertical tube or sleeve.

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