Debate: Lifestyle or surgery for type 2 diabetes remission? IDF2022 EndoTwitter
"We need studies that compare the efficacy and safety of these procedures with that of truly intensive lifestyle intervention like the DiRECT trial, not just standard practice, and we need a true cost-benefit analysis," he concluded.
Makkar started by noting that the concept of type 2 diabetes remission with bariatric surgery dates back several decades. In And in five large randomized controlled clinical trials conducted between 2006 and 2013 with follow-up of 1 or 2 years, the type 2 diabetes remission rate ranged from 39.4% to 93%, compared with 0% to 46.7% with conventional treatment.published in 2022 included 316 patients with type 2 diabetes who were enrolled in four trials in which metabolic surgery was comapred with medical/lifestyle treatment. The proportions with A1c of <6.5% without glucose lowering therapy at 3 years were 37.
Few, if any, studies of lifestyle intervention have lasted beyond 2 years, Makkar noted."We all know lifestyle interventions aren't easy to do," he added.
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