Bariatric surgery


Roundup: Weight-Loss Surgery Enables Long-Term Control, Remission of Type 2 Diabetes; COVID Linked to Measurable Cognitive Decline; and More News

Bariatric Surgery Provides Long-Term Blood Sugar Control, Type 2 Diabetes Remission, NIH Study Finds

People with type 2 diabetes who underwent bariatric surgery achieved better long-term blood glucose control, compared to those who were treated with nonsurgical therapies including medication and lifestyle modifications, according to a new study supported by the National Institutes of Health (NIH).

The participants who underwent bariatric surgery, also called weight-loss surgery, were also “more likely to stop needing diabetes medications and had higher rates of diabetes remission up to 12 years post-surgery,” states the NIH in a news release. Results of the study, funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of NIH, were published in JAMA.

The latest study is a follow-up to four independent, single-center randomized trials conducted between May 2007 and August 2013 at U.S. clinical sites. The earlier trials compared bariatric surgery to intensive lifestyle and medication therapy involving oral and injectable diabetes medications, including insulin, for adults with type 2 diabetes and those overweight or obese.

Bariatric surgery, or weight-loss surgery, reduces the size of your stomach and limits the number of calories you absorb.

“While there are many factors involved, and not all of them are completely understood, bariatric surgery typically results in greater weight loss that affects a person’s metabolic hormones, which improves the body’s response to insulin and ability to maintain healthy blood glucose levels,” said Jean Lawrence, M.D., NIDDK project scientist, in a statement. “These results show that people with overweight or obesity and type 2 diabetes can make long-term improvements in their health and change the trajectory of their diabetes through surgery.”

At seven years, participants in the bariatric surgery group realized an average 20 percent weight loss compared to 8 percent among those in the medical/lifestyle group. The surgery group had greater improvements in blood glucose control, measured by HbA1c, with 54 percent of participants in the surgery group achieving an HbA1c less than 7 percent, compared to only 27 percent of participants in the medical/lifestyle group. (HbA1c is a test used to diagnose type 2 diabetes. To classify in the normal range or non-diabetic range, the value should be below 5.7 percent.)

According to the NIH: “More participants with surgery achieved diabetes remission, compared to participants in the medication/lifestyle group, and the percent of participants using medications to treat diabetes in the surgery group decreased from 98 percent to 61 percent, yet remained largely unchanged in the medication/lifestyle group.”

Long COVID Produces Measurable Cognitive Decline Even in Those Who Have Recovered

COVID-19, which can produce so-called “brain fog” symptoms in some people, may cause small but measurable declines in cognitive and memory tasks, even in people who have recovered from COVID, compared to those who have not contracted the virus, according to a new study by Imperial College London researchers.

Of the cognitive impairments noted, “memory, reasoning, and executive function (i.e., planning) tasks were the most sensitive and had the largest deficits in the group with unresolved (long COVID) persistent symptoms,” the study, published in the New England Journal of Medicine, finds.

The findings involve people who had long-duration symptoms (Long COVID) that had eventually resolved. The study also shows that the cognitive deficits were larger for people who were hospitalized, who had lingering symptoms, or who were infected with earlier variants of the virus, states a news release from Imperial College London.

Cognitive testing of nearly 113,000 people in England found that participants with long COVID  symptoms scored the equivalent of 6 I.Q. points lower than people who had never been infected. Those who had been infected with COVID, but no longer had symptoms, also scored slightly lower than people who had never been infected -- by the equivalent of 3 I.Q. points.

“We also found a small cognitive advantage among participants who had received two or more vaccinations and a minimal effect of repeat episodes of COVID-19,” states the study.

The study concludes: “Participants with resolved persistent symptoms after COVID-19 had objectively measured cognitive function similar to that in participants with shorter-duration symptoms, although short-duration COVID-19 was still associated with small cognitive deficits after recovery. Longer-term persistence of cognitive deficits and any clinical implications remain uncertain.”

FDA: Don’t Use ‘Smart Watches or Smart Rings’ Claiming to Measure Blood Sugar Without Piercing the Skin

The U.S. Food and Drug Administration (FDA) is warning consumers, particularly those who are diabetic, about the risks of using smartwatches or smart rings that claim to measure blood glucose levels (blood sugar) without piercing the skin.

“These devices are different than smartwatch applications that display data from FDA-authorized blood glucose measuring devices that pierce the skin, like continuous glucose monitoring devices (CGMs),” the FDA states in its warning. “The FDA has not authorized, cleared, or approved any smartwatch or smart ring that is intended to measure or estimate blood glucose values on its own.”

Consult with your physician If your medical care depends on accurate blood-glucose measurements about an appropriate FDA-authorized device.

For diabetics, inaccurate blood glucose measurements “can lead to errors in diabetes management, including taking the wrong dose of insulin, sulfonylureas, or other medications that can rapidly lower blood glucose,” the FDA states. Taking too much of these medications can quickly lead to dangerously low glucose levels and result in mental confusion, coma, “or death within hours of the error,” the agency adds.

These devices are manufactured and sold by dozens of companies under many different brand names. They claim that these devices measure blood glucose levels without requiring people to prick the finger or pierce the skin.

“These smartwatches and smart rings do not directly test blood glucose levels,” the FDA states.

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