Bariatric surgery could help control diabetes over the long term

by Barbara Hewitt on September 25, 2013

A gastric bypass surgery for overweight people with type 2 diabetes is being considered as an early option for those who cannot control the condition.

While several studies have shown that bariatric surgery can help treat diabetes the latest research from Cleveland Clinic’s Bariatric and Metabolic Institute in the United States shows it continues to work over the long term.

bypass surgery diabetes

Data show that diabetes remission occurred in 50% of patients after bariatric surgery after 6 years.

The institute’s research found that overweight patients with type 2 diabetes continued to experience the benefits of bariatric surgery up to nine years after the procedure. The trial also showed that the surgery lowers the risk of cardiovascular problems over the same nine year period.

The researchers also identified the factors that result in a higher rate of long term diabetes remission. For example, undergoing gastric bypass surgery compared to adjustable gastric banding worked better for sustained diabetes remission.

‘The procedure can offer durable remission of diabetes in some patients and should be considered as an earlier treatment option for patients with uncontrolled diabetes,’ said lead researcher Dr Stacy Brethauer, a bariatric surgeon at the Cleveland Clinic Bariatric and Metabolic Institute (BMI.)

It was also found that those who had the surgery within five years of being diagnosed with diabetes kept the condition under control better as did those who managed long term weight loss.

‘Uncontrolled diabetes can lead to serious complications such as heart and kidney disease. Only about half of diabetics in the United States currently have acceptable control of their blood glucose level,’ said Brethauer, adding, ‘Our study, however, shows that 80% of the diabetic patients still control their blood glucose five years after their bariatric surgery. Additionally, nearly one third of gastric bypass patients had normal blood glucose levels off medication for over five years after surgery.’

The study analysed data on 217 patients with type 2 diabetes who underwent bariatric surgery between 2004 and 2007 and had at least five years follow up. The patients were divided into three groups. The first of 162 patients underwent gastric bypass surgery, 32 had the gastric banding procedure done, and 23 underwent sleeve gastrectomy.

At a follow up after six years, data show that diabetes remission occurred in 50% of patients after bariatric surgery. Specifically, 24% of patients sustained complete remission of their diabetes with a blood sugar level of less than 6% without diabetes medications, and another 26% achieved partial remission. Some 34% of all patients improved their long term diabetes control compared to pre-surgery status.

Patients who received gastric bypass experienced the highest rates of weight loss and diabetic remission and there was a significant reduction in the amount of diabetic medications used in the long term follow up. There was a 50% reduction in the number of patients requiring insulin therapy in the long term and a 10-fold increase in the number of patients requiring no medications.

Cleveland Clinic researchers have been at the forefront of research in this field. They led the groundbreaking STAMPEDE (Surgical Therapy and Medications Potentially Eradicate Diabetes Efficiently) trial which was the first to show that bariatric surgery is more effective than medical therapy in controlling diabetes in obese patients.

Additional pioneering research in the field includes a Cleveland Clinic led sub study of STAMPEDE which found that gastric bypass surgery reverses diabetes by uniquely restoring pancreatic function in moderately obese patients with uncontrolled type 2 diabetes.

With the publication of this new trial, Cleveland Clinic researchers further advance the body of research on bariatric surgery as a treatment option for patients with uncontrolled diabetes.

The opinions expressed in this article do not necessarily reflect the views of the Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

{ 1 comment… read it below or add one }

Gretchen | Batriatric Surgery October 7, 2013 at 12:24 am

Obesity and weight loss treatment and surgeries are generally only an option for people who are more than 100 pounds overweight. Most physicians will first suggest a wide variety of treatments such as behavior modification, dieting, and exercise. Sometimes, a doctor will prescribe medications. When these fail, surgery is an option for those who have not responded to such treatments and who are severely obese.


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