|By PR Newswire||
|March 31, 2014 08:02 AM EDT||
CLEVELAND, March 31, 2014 /PRNewswire/ -- A study by Cleveland Clinic researchers shows bariatric surgery is a highly effective and durable treatment for type 2 diabetes in obese patients, enabling nearly all surgical patients to be free of insulin and many to be free of all diabetic medications three years after surgery.
The STAMPEDE (Surgical Therapy And Medications Potentially Eradicate Diabetes Efficiently) trial was simultaneously published in The New England Journal of Medicine and presented today at the Annual Scientific Session of the American College of Cardiology in Washington, D.C.
The study also shows that bariatric surgery patients experienced an improvement in quality of life and a reduction in the need for cardiovascular medications to control blood pressure and cholesterol compared to those receiving medical therapy. As a result, patients in the surgery groups used less cardiovascular and glucose-lowering medications – 5 to 10 percent were on insulin compared to 55 percent of the patients in the medical therapy group.
Obesity is the main trigger for type 2 diabetes. Given that an estimated one in every three adults in the United States is obese, health experts developed the term "diabesity" to talk about this epidemic. According to the American Diabetes Association, as many as one in three American adults will have diabetes in 2050 if present trends continue.
"We see patients whose lives are ravaged by diabetes. At the three-year mark, this study shows that bariatric surgery is more effective with persistent benefits noted up to 3 years for treating type 2 diabetes in moderate and severely obese patients when compared to medical therapy," said Sangeeta Kashyap, M.D., one of the lead investigators and an endocrinologist at Cleveland Clinic's Endocrinology & Metabolism Institute. "More than 90 percent of the patients who underwent bariatric surgery were able to lose 25 percent of their body weight and control their diabetes without the use of insulin and multiple diabetes drugs."
To date, the STAMPEDE study is the largest randomized trial with one of the longest follow-ups comparing medical therapy with bariatric surgery. The trial initially involved 150 overweight patients with poorly controlled diabetes. The patients were divided into three groups: 1) Fifty patients received intensive medical therapy only, including counseling and medications; 2) Fifty patients underwent Roux-en-Y gastric bypass surgery and received medical therapy; 3) Fifty patients underwent sleeve gastrectomy and received medical therapy.
Effectiveness was gauged by the percentage of patients who achieved blood sugar control, defined in this study as hemoglobin HbA1c level of less than or equal to 6.0 percent – a more aggressive target than the American Diabetes Association's guidelines. HbA1c is a standard laboratory test that reflects average blood sugar over three months.
At the three-year mark, more patients in the gastric bypass group (37.5 percent) achieved blood sugar control without the use of any diabetic medications compared with the other two groups -- 5 percent of the patients in the medical therapy group and 24.5 percent of the patients in the sleeve gastrectomy group. This correlates with a weight loss five to six times greater on average for patients who underwent bariatric surgery compared with those in the intensive medical therapy group.
"The three-year data confirm that bariatric surgery maintains its superiority over medical therapy for the treatment of type 2 diabetes in severely obese patients," said lead investigator Philip Schauer, M.D., Director of the Cleveland Clinic Bariatric and Metabolic Institute. "Moreover, data show that bariatric surgery is as effective in treating type 2 diabetes in patients with mild obesity. That's why Cleveland Clinic health insurance plan now covers bariatric surgery for its members with mild obesity and uncontrolled diabetes."
After three years, researchers were also able to evaluate the impact of diabetes and obesity on the patients' quality of life using a validated questionnaire (SF-36, Rand Corp.). Data show significant improvements in five of eight mental and physical domains for patients in the gastric bypass group and two of eight domains for the patients in the sleeve gastrectomy group. There was no improvement in the medical therapy group.
"We looked at quality of life, because ultimately it is all about helping our patients live a healthier, happier life," said Dr. Schauer. "When compared to sleeve gastrectomy and medical therapy, gastric bypass patients achieved greater weight loss, were on fewer medications, had a higher success rate in controlling their diabetes, and an improved quality of life."
In addition, new data looked at kidney function, measured by the amount of albumin in the urine and a marker of kidney damage due to diabetes. Albumin level was significantly lower in the gastric bypass group only.
Cleveland Clinic researchers have been at the forefront of research in this field. In addition to leading the STAMPEDE trial, pioneering Cleveland Clinic-led research includes a study showing for the first time that bariatric surgery can markedly improve type 1 diabetes, with some patients reducing their insulin intake by more than 60 percent. The results were published in the March 2014 issue of Diabetes Care.
A substudy of STAMPEDE, published in Diabetes Care in 2013, found that gastric bypass surgery reverses diabetes by uniquely restoring pancreatic function in moderately obese patients with uncontrolled type 2 diabetes.
Further research is needed to continue to advance the study of bariatric surgery as a treatment option for patients with diabetes.
More information on the STAMPEDE clinical trial can be found at clevelandclinic.org/stampede.
The STAMPEDE study was funded by Ethicon, part of the Johnson & Johnson family of companies, through its Metabolic Applied Research Strategy (MARS) program. The NIH grant number is R01 DK089547.
Dr. Schauer is a paid consultant for Ethicon.
About Cleveland Clinic
Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S.News & World Report consistently names Cleveland Clinic as one of the nation's best hospitals in its annual "America's Best Hospitals" survey. More than 3,000 full-time salaried physicians and researchers and 11,000 nurses represent 120 medical specialties and subspecialties. The Cleveland Clinic health system includes a main campus near downtown Cleveland, eight community hospitals, more than 75 Northern Ohio outpatient locations, including 16 full-service Family Health Centers, Cleveland Clinic Florida, the Lou Ruvo Center for Brain Health in Las Vegas, Cleveland Clinic Canada, and, currently under construction, Cleveland Clinic Abu Dhabi. In 2012, there were 5.1 million outpatient visits throughout the Cleveland Clinic health system and 157,000 hospital admissions. Patients came for treatment from every state and from more than 130 countries. Visit us at www.clevelandclinic.org. Follow us at www.twitter.com/ClevelandClinic.
Editor's Note: Cleveland Clinic News Service is available to provide broadcast-quality interviews and B-roll upon request.
SOURCE Cleveland Clinic
DevOps approaches within “Unicorns” vary significantly from the reality of DevOps in the enterprise. Most enterprises manage portfolios of heterogeneous applications that are increasingly interconnected, delivered by global teams, at various stages of technology maturity, and are often encumbered by additional compliance and governance obligations. In his session at DevOps Summit, Dalibor Siroky, Director and co-founder at Plutora, will discuss the emerging and evolving experiences of Agile, Co...
May. 6, 2015 10:00 PM EDT Reads: 671
Artifactory binary repository management system. As one of the most widely used binary repositories and the only repository that offers a high availability clustered solution, the integration with Artifactory helps customers easily adopt CA Release Automation to optimize their entire software development lifecycle. “Artifactory is a standard maker at the continuous-integration domain and provides the user a powerful repository experience with the freedom to choose his own tools set and ecosyste...
May. 6, 2015 08:30 PM EDT Reads: 718
Zerto has announced the general availability of Zerto Virtual Replication 4.0 (ZVR 4.0). The company’s enterprise-class business continuity/disaster recovery (BC/DR) software is the first to protect, replicate, and migrate data between VMware vSphere and Microsoft Hyper-V hypervisors, as well as across private, hybrid and public cloud environments including Amazon Web Services (AWS). ZVR 4.0 also allows channel partners and cloud service providers to expand their offerings to grow revenues by pr...
May. 6, 2015 07:30 PM EDT Reads: 709
With major technology companies and startups seriously embracing IoT strategies, now is the perfect time to attend @ThingsExpo in Silicon Valley. Learn what is going on, contribute to the discussions, and ensure that your enterprise is as "IoT-Ready" as it can be! Internet of @ThingsExpo, taking place Nov 3-5, 2015, at the Santa Clara Convention Center in Santa Clara, CA, is co-located with 17th Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading in...
May. 6, 2015 06:30 PM EDT Reads: 969
@ThingsExpo has been named the Top 5 Most Influential Internet of Things Brand by Onalytica in the ‘The Internet of Things Landscape 2015: Top 100 Individuals and Brands.' Onalytica analyzed Twitter conversations around the #IoT debate to uncover the most influential brands and individuals driving the conversation. Onalytica captured data from 56,224 users. The PageRank based methodology they use to extract influencers on a particular topic (tweets mentioning #InternetofThings or #IoT in this ...
May. 6, 2015 06:15 PM EDT Reads: 2,749
While Docker continues to be the darling of startups, enterprises and IT innovators around the world, networking continues to be a real mess. Indeed, managing the interaction between Docker containers and networks has always been fraught with complications. Without automation in networking, the vision of running Docker at scale and letting IT run the same apps unchanged on the laptop and in the data center or for any cloud cannot be realized.
May. 6, 2015 05:00 PM EDT Reads: 1,031
DevOps Summit, taking place Nov 3-5, 2015, at the Santa Clara Convention Center in Santa Clara, CA, is co-located with 17th Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry players in the world. The widespread success of cloud computing is driving the DevOps revolution in enterprise IT. Now as never before, development teams must communicate and collaborate in a dynamic, 24/7/365 environment. There is no time to wait for long developmen...
May. 6, 2015 05:00 PM EDT Reads: 1,084
17th Cloud Expo, taking place Nov 3-5, 2015, at the Santa Clara Convention Center in Santa Clara, CA, will feature technical sessions from a rock star conference faculty and the leading industry players in the world. Cloud computing is now being embraced by a majority of enterprises of all sizes. Yesterday's debate about public vs. private has transformed into the reality of hybrid cloud: a recent survey shows that 74% of enterprises have a hybrid cloud strategy. Meanwhile, 94% of enterprises a...
May. 6, 2015 04:45 PM EDT Reads: 857
Why does developer experience matters, what makes for a great developer experience and what is the relationship between developer experience and the broader field of user experience? Software developers are gaining more influence over the purchase decisions of technologies with which they must build on and with which they must integrate. For example, the success of Amazon Web Services, Heroku and MongoDB has been driven primarily by individual software developers choosing to use these tools, ra...
May. 6, 2015 04:45 PM EDT Reads: 699
Enterprise IoT is an exciting and chaotic space with a lot of potential to transform how the enterprise resources are managed. In his session at @ThingsExpo, Hari Srinivasan, Sr Product Manager at Cisco, will describe the challenges in enabling mass adoption of IoT, and share perspectives and insights on architectures/standards/protocols that are necessary to build a healthy ecosystem and lay the foundation to for a wide variety of exciting IoT use cases in the years to come.
May. 6, 2015 04:30 PM EDT Reads: 1,303
SYS-CON Events announced today Isomorphic Software, the global leader in high-end, web-based business applications, will exhibit at SYS-CON's DevOps Summit 2015 New York, which will take place on June 9-11, 2015, at the Javits Center in New York City, NY. Isomorphic Software is the global leader in high-end, web-based business applications. We develop, market, and support the SmartClient & Smart GWT HTML5/Ajax platform, combining the productivity and performance of traditional desktop software ...
May. 6, 2015 03:00 PM EDT Reads: 956
Avnet, Inc. has announced that it ranked No. 4 on the InformationWeek Elite 100 – a list of the top business technology innovators in the U.S. Avnet was recognized for the development of an innovative cloud-based training system that serves as the foundation for Avnet Academy – the company’s education and training organization focused on technical training around top IT vendor technologies. The development of this system allowed Avnet to quickly expand its IT-related training capabilities around...
May. 6, 2015 02:45 PM EDT Reads: 1,072
Docker is becoming very popular--we are seeing every major private and public cloud vendor racing to adopt it. It promises portability and interoperability, and is quickly becoming the currency of the Cloud. In his session at DevOps Summit, Bart Copeland, CEO of ActiveState, discussed why Docker is so important to the future of the cloud, but will also take a step back and show that Docker is actually only one piece of the puzzle. Copeland will outline the bigger picture of where Docker fits a...
May. 6, 2015 02:15 PM EDT Reads: 5,387
This talk focuses on the application of DevOps fundamentals to include network infrastructure. It draws from real deployment case studies on the extension of today's paradigms to address the challenges of the network infrastructures' ability to seamlessly and cohesively integrate into agile workflows. In this session at DevOps Summit, Arista Networks will focus on configuration management using automation with a nod to future work necessary to include telemetry and ephemeral state information....
May. 6, 2015 01:30 PM EDT Reads: 1,281
@ThingsExpo has been named the Top 5 Most Influential M2M Brand by Onalytica in the ‘Machine to Machine: Top 100 Influencers and Brands.' Onalytica analyzed the online debate on M2M by looking at over 85,000 tweets to provide the most influential individuals and brands that drive the discussion. According to Onalytica the "analysis showed a very engaged community with a lot of interactive tweets. The M2M discussion seems to be more fragmented and driven by some of the major brands present in the...
May. 6, 2015 12:15 PM EDT Reads: 5,894