Metabolic Surgery โShows Superiority to GLP-1 Agonists in Long-Term Outcomes for Diabetes and โObesity, Landmark Study Reveals
LONDON โฃ – In a perhaps practice-changing finding, metabolic surgery demonstrated substantially greater benefits thanโข glucagon-likeโข peptide-1 receptor agonists (GLP-1 RAs) in mitigating both macrovascular and microvascular complications among โคpatients with diabetes and obesity, according โฃtoโฃ research published todayโ inโ The Lancet. The multi-national, randomized controlled โtrial-theโค largest of its kind-followed participants for up to ten years, โฃchallenging conventional treatment paradigmsโ and offering a new avenueโ for managing โthese increasingly prevalent conditions.
The study, involving 3,041 adults with type 2 diabetes and obesity, provides compelling โevidence that bariatric surgery isn’t solely โa weight-loss intervention, but a powerful tool for reducing the long-term health risks associated โขwithโ metabolic disease. With diabetes and obesityโ rates continuing to climb globally, impacting hundreds of millions and straining healthcare systems, the findings underscore the need to โreassess treatment strategies โand consider metabolic surgery as a viable option for a broader patient population. the research teamโข anticipates these results will fuel further discussion regarding access to, and coverage of, metabolic surgery as a preventative โmeasure against debilitatingโข and life-threatening complications.
Researchers, led by Dr.Simonโ Heller at the University of โคSheffield, randomly assigned participants โคto either metabolic surgery (various procedures including gastric bypass and sleeve gastrectomy) โor guideline-basedโค medical therapy with โคGLP-1 RAs. The primary outcome was the โฃfirstโค occurrence of a โคmajor adverse cardiovascular โขevent (MACE), defined as a composite of cardiovascular death, non-fatal โmyocardial infarction, or non-fatal stroke.
Over a median follow-up of 5.8 years, the surgery group exhibited a 20% โreduction in the risk of MACE compared to the GLP-1 RA group (hazard ratio 0.80,โ 95% confidenceโ intervalโฃ 0.67-0.96, p=0.017). โ โคFurthermore, theโข surgery group demonstrated aโค 39% โฃreduction in microvascular complications, โขincluding nephropathy, neuropathy, and retinopathy (hazard ratio 0.61, 95% confidence intervalโ 0.49-0.76, p<0.0001).
Whileโ both groups experienced significant weight loss and improvements โขin HbA1c levels, โขthe sustained โฃbenefitsโค observed in the surgery groupโ were markedly more pronounced. โฃ Theโ study also noted a higher rate of serious adverseโ events in โขthe โsurgeryโ group,but researchers emphasize that these risks must be โweighed against the โlong-termโ benefits of โreduced โฃcardiovascular and microvascular disease.
“These results clearly demonstrate that metabolic surgery offers a more durable and thorough benefit than medical therapy โขwith GLP-1 โฃreceptor agonists in reducing theโข long-term complications of โคdiabetes and obesity,” stated Dr. Heller.”Theโ findings support the consideration of metabolic surgeryโค as a key component โof a comprehensive treatment strategy for eligible patients.”
the research was fundedโ by the National Institute for Healthโค andโฃ Care Research โฃ(NIHR) and supported by variousโ international โคinstitutions.โฃ Further analysis is planned to explore the cost-effectivenessโ of metabolic surgery comparedโค toโ ongoing medical management.
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