Despite similar weight loss, teens who had gastric bypass surgery were significantly more likely to have remission of both type 2 diabetes and high blood pressure, compared to adults who had the same procedure. Results are from a study comparing outcomes in the two groups five years after surgery. Previously, no treatment has shown longer-term effectiveness at reversing type 2 diabetes in youth, which tends to advance more quickly than in adults.
Researchers evaluated 161 teens and 396 adults who underwent this surgery at clinical centers participating in Teen-LABS (Teen-Longitudinal Assessment of Bariatric Surgery) and its adult counterpart, LABS. Teens in the study were under 19 years old at the time of surgery, and adults in the study reported having obesity by age 18. Teen-LABS clinical centers had specialized experience in the surgical evaluation and management of young people with severe obesity. The results were published in The New England Journal of Medicine.
"Obesity increases the risk for type 2 diabetes and cardiovascular diseases, and these conditions can be more difficult to manage in young people," said a study author and program director. "We found earlier bariatric surgery in carefully selected youth may have greater benefits compared to waiting until later in life."
Key findings of the research include:
-
Overall weight loss percentage was not different between the groups. Teens lost 26% of their bodyweight and adults lost 29% at five years after surgery.
-
Type 2 diabetes declined in both groups, but teens with type 2 diabetes before surgery were 27% more likely than adults to have controlled blood glucose (blood sugar) without the use of diabetes medications.
-
No teens in the group needed diabetes medications after surgery, compared to 88% of teens before surgery. 79% of adults used diabetes medications before surgery, and 26% used diabetes medications five years later.
-
Before surgery, 57% of teens and 68% of adults used blood pressure medications. Five years after surgery, 11% of teens and 33% of adults used blood pressure medications.
-
Among those with high blood pressure before surgery, teens were 51% more likely than adults to no longer have high blood pressure or take blood pressure medication.
However, teens were more likely to have increased risks in other areas, including a need for subsequent abdominal surgeries, most commonly gall bladder removal. Teens were also more likely to have low iron and vitamin D levels, potentially because teens may be less likely to take enough vitamin and mineral supplements after surgery. There was a similar death rate for both teens and adults five years after surgery, including two people from the teen group who died from overdose. There is an overall increasing trend of drug overdose deaths in the U.S., and a previous LABS study found an increased risk of substance and alcohol use disorders after bariatric surgery in adults.
"Although there are risks associated with bariatric surgery, this study demonstrates that, for many young people, the benefits likely outweigh the risks," said the study's first author. "Sufficient vitamin and mineral supplementation, along with continued medical care, can help mitigate some of these risks."
These results build on earlier research related to the benefits, risks, and timing of bariatric surgery to aid in weight management. Obesity affects more than one in three adults and about 17% of American children and teens. Obesity increases risk for type 2 diabetes, heart and kidney diseases, some types of cancer, and other health conditions.
"Type 2 diabetes in youth has been a growing problem without a solution, hitting young adults with serious health conditions when they should be in the prime of their lives. This study demonstrates that bariatric surgery may provide an effective treatment, though not one without risks," said another author. "We hope future research continues to shed light on the best timing and the most effective treatments for all people with weight-related conditions."
https://www.nih.gov/news-events/news-releases/early-weight-loss-surgery-may-improve-type-2-diabetes-blood-pressure-outcomes
https://www.nejm.org/doi/full/10.1056/NEJMoa1813909
Latest News
The assembly of the human c…
By newseditor
Posted 24 Apr
Wiring of the human neocortex
By newseditor
Posted 24 Apr
Abusive drugs hijack natura…
By newseditor
Posted 23 Apr
Mechanism of action of the…
By newseditor
Posted 23 Apr
Role of fat in rare neurolo…
By newseditor
Posted 23 Apr
Other Top Stories
New HIV vaccine target!
Read more
Twin study finds that gut microbiomes run in families
Read more
Genetically engineered world's first Zika virus infectious cDNA clone!
Read more
How antibodies access neurons to fight infection
Read more
Why humans (and not mice) are susceptible to Zika
Read more
Protocols
A programmable targeted pro…
By newseditor
Posted 23 Apr
MemPrep, a new technology f…
By newseditor
Posted 08 Apr
A tangible method to assess…
By newseditor
Posted 08 Apr
Stem cell-derived vessels-o…
By newseditor
Posted 06 Apr
Single-cell biclustering fo…
By newseditor
Posted 01 Apr
Publications
Integrative spatial analysi…
By newseditor
Posted 24 Apr
Time-series reconstruction…
By newseditor
Posted 24 Apr
Harnessing gastrointestinal…
By newseditor
Posted 24 Apr
Sex-specific modulation of…
By newseditor
Posted 24 Apr
Exploiting pancreatic cance…
By newseditor
Posted 23 Apr
Presentations
Hydrogels in Drug Delivery
By newseditor
Posted 12 Apr
Lipids
By newseditor
Posted 31 Dec
Cell biology of carbohydrat…
By newseditor
Posted 29 Nov
RNA interference (RNAi)
By newseditor
Posted 23 Oct
RNA structure and functions
By newseditor
Posted 19 Oct
Posters
A chemical biology/modular…
By newseditor
Posted 22 Aug
Single-molecule covalent ma…
By newseditor
Posted 04 Jul
ASCO-2020-HEALTH SERVICES R…
By newseditor
Posted 23 Mar
ASCO-2020-HEAD AND NECK CANCER
By newseditor
Posted 23 Mar
ASCO-2020-GENITOURINARY CAN…
By newseditor
Posted 23 Mar