Gastric bypass helps control type 2 diabetes, but side effects abound: study

by Barbara Hewitt on May 27, 2015

Two years after surgery, people who have had gastric bypass have better control of their type 2 diabetes than people who did not, new research has confirmed.

But there is a down side as international researchers also found that those who have had surgery also had a higher risk of infections and bone fractures.


Researchers fear that gastric bypass surgery has more serious negative effects than it does positive ones

Some doctors had thought that gastric bypass could cure type 2 diabetes, but that did not happen for most patients, according to study co-author Dr. Charles Billington of the endocrinology and diabetes division at the University of Minnesota, Minneapolis.

‘Also unexpected was the extent of complications in the bypass patients. Gastric bypass now appears to have less strong positives and more worrisome negatives than previously thought,’ he added.

The study results are based on two years of the ongoing Diabetes Surgery Study. Between 2008 and 2011, researchers looked sat the records of 120 obese patients aged 30 to 67 years old with type 2 diabetes at three teaching hospitals in the US and one in Taiwan. They were randomly divided into two groups: lifestyle and medical diabetes management, or lifestyle and medical management in addition to gastric bypass surgery.

The lifestyle group met regularly with a dietitian or nurse, were instructed to weigh themselves and record their food intake daily and increasing their exercise to 325 minutes of activity, such as walking, per week. They also met with an endocrinologist and took medicines for blood sugar control, cholesterol and blood pressure as needed. The gastric bypass group had access to the same resources in addition to weight loss surgery.

Two years after surgery, 24 of the patients in the gastric bypass group achieved lower HbA1c, as well as lower low density lipoprotein cholesterol and lower blood pressure. Together these indicated improved diabetes control, relative to eight patients in the comparison group.

There were eight infections in the gastric bypass group, compared to four in the comparison group, and the bypass group had seven serious falls with five fractures compared to three serious falls and one fracture in the comparison group. All those suffering fractures were women. Nutritional deficiencies of iron, calcium and vitamin D were also more common in the gastric bypass group.

Billington explained that a gastric bypass may reduce bone strength because of reduced calcium absorption from food, so clinicians need to be aware the supplements need to be adjusted to be sure they are sufficient.

‘Carefully taking nutritional supplements, regularly checking with your doctor about the adequacy of these supplements, and maintaining physical fitness reduces the risk of adverse events’ he said.

He also pointed out that researchers are still not sure of which diabetic patients would be best to consider for gastric bypass or other bariatric surgery. ‘Hopefully this and other studies will help identify which patients are best suited for gastric bypass to treat diabetes,’ he added.

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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