A 2-year long investigator led clinical trial done by Dr Shashank Shah on 80 obese Asian Indian diabetics have successfully proved the efficacy of gastric bypass surgery as a superior treatment option to medical management of diabetes currently in practice through medication and lifestyle changes.
The Ethicon funded trial showed that almost 65 per cent of mildly over weight patients with uncontrolled diabetes who underwent surgery achieved total disease remission.
The findings of the clinical trial were acknowledged and recognised at the American Diabetes Association (ADA) 76th Scientific Session held between June 10 and June 14, 2016 at the Ernest N Morial Convention Center in New Orleans.
“Current medical and lifestyle treatments for Asian Indians who suffer from obesity and type 2 diabetes are often inadequate to control morbidities and mortalities associated with these conditions. Comparison of Surgery vs. Medicine for Indian Diabetes (COSMID) provides evidence that gastric bypass is a superior treatment to medical management alone, and could be an option for patients who qualify,” concluded Dr. Shah.
COSMID is the first study to specifically address the Asian Indian population which has a different pathogenesis of type 2 diabetes than Caucasians. Additionally, the results of the trial also could apply to other populations that tend to develop type 2 diabetes and other obesity related conditions at lower BMI’s than Caucasians.
The study bears relevance as Asian Indians have a ethnic and genetic predisposition for developing diabetes at a younger age and at lower body mass index than the Caucasian population.
The clinical trial is a part of a 5-year international scientific collaboration among Dr. Shah, David Cummings, MD from the University of Washington, and Keith Kim, MD, Celebration Health, Florida. The COSMID trial two-year results, along with the recent five-year results of the STAMPEDE study, build on the existing body of evidence, demonstrated that surgery is a highly effective treatment for obesity related diabetes for certain patients.
Dr Shah also received this year’s ADA’s prestigious Vivian Fonseca Scholar Award for the study which recognizes diabetes research focused on the South Asian, Asian American, Native Hawaiian, and Pacific Islander populations and/or research by a scientist from these areas of the world.
Indian population is the third most obese in the world according to a Lancet Global Burden of Disease study 2013 and obesity is the number one cause of type 2 diabetes in India. Over 80 per cent of adult diabetics in India are clinically overweight.
From creating the first sutures, to revolutionizing surgery with minimally invasive procedures, Ethicon has made significant contributions to surgery for nearly 60 years.
“There are more than 300 million people suffering from obesity in India and type 2 diabetes is growing at an alarming rate there. When compared to Caucasians, the Asian Indian population tends to get sick from diabetes at a lower BMI, but it was unclear if bariatric surgery would be as effective in less obese population. The COSMID trial filled that knowledge gap and the results prove that bariatric surgery is more effective at managing and controlling type 2 diabetes than medical and lifestyle management alone for this group,” said Dr. Elliott Fegelman, Therapeutic Area Expert, Metabolics, Johnson & Johnson Innovations.
At the same weight as a Caucasian, an Asian Indian is at greater risk for obesity-related conditions such as heart disease and diabetes.
COSMID randomized trial has compared the impact of Roux-en Y gastric bypass (plus medical therapy as needed) vs. optimal medical and lifestyle management among Asian Indian adults with type 2 diabetes and a BMI between 25 and 40 kg/m2.