Capacity to produce insulin holds secret to success of weight loss surgery for diabetics

by Barbara Hewitt on November 30, 2015

The ability to produce insulin is pivotal to the success of weight loss surgery in patients with type 2 diabetes, according to new research from a team in Denmark.

The study provides a better point of departure for advice and determining which patients will benefit from surgery, as the production of insulin determines the success of what is a major surgical procedure.

bypass surgery diabetes“Our study shows that the patients’ ability to produce insulin is decisive for whether or not the procedure eliminates diabetes,” said Professor Flemming Dela from the Centre for Healthy Aging and Department of Biomedical Science at the University of Copenhagen. “Measuring the insulin cells’ performance before surgery can thus provide us with a much better basis from which to predict who will actually benefit from the surgery. This type of measurement is not currently included in doctors’ assessments.”

In the study, researchers measured the insulin-producing cells’ ability to produce insulin twice prior to and twice following the surgery. Four months after the surgery, 57% of the patients with the best insulin-producing cells prior to the procedure no longer had diabetes, while there was no change in the group of patients with poor insulin-producing cells.

The research also found that 18 months after the surgery, 71% of those in the group with the best insulin-producing cells no longer had diabetes, as opposed to 38% in the group with the poorest insulin-producing cells.

The research report points out that weight loss surgery constitutes a substantial surgical procedure and the doctors’ ability to predict which patients will actually benefit from weight loss surgery is thus important, not only to the patients but also to the economy.

Researchers have long known that the weight loss that accompanies a weight loss surgery also improves the effectiveness of insulin. Up until now, they believed that improved insulin sensitivity was a prerequisite for the elimination of diabetes. However, this new study reveals that the decisive factor is in fact the capacity to produce insulin.

“The ability to produce sufficient amounts of insulin is inversely related to duration of the disease. The longer the patient has had diabetes, the poorer the ability to produce insulin,” said Dela. “Thus, these new results also point to the importance of undergoing an operating at an early stage, before the patients lose their ability to produce insulin.”

However, he also said that more studies are needed before the test can be included in the preliminary examinations of patients awaiting a weight loss surgery and help determine the amount of insulin needed to ensure a successful procedure.

And he pointed out that measuring insulin is not standardised across laboratories, and this is a prerequisite for the test to be included in preliminary examinations.

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.

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