In a study published online in Diabetes Care, Ali Tavakkoli, MD, co-director of Center for Weight Management and Metabolic Surgery at Brigham and Women's Hospital, and co-authors evaluated the impact of bariatric surgeries on insulin-treated type 2 diabetes (I-T2D) in the general population. Although other studies have reported on the outcome of bariatric operations on diabetic patients, few studies had assessed the impact of surgery on the severest of the diabetics: those requiring insulin.
In a study involving more than 5,000 patients, they found that even in cases of advanced diabetes, surgery can lead to beneficial outcomes. They found that 62 percent of insulin-treated type 2 diabetes patients who undergo a Roux-en Y gastric bypass surgery (RYGB) stop taking insulin one year later. Among patients who underwent a a laparoscopic adjustable gastric banding (LAGB), researchers noted that the likelihood of insulin cessation was 34 percent. Additionally, clinical remission of diabetes was observed in 50. 3 percent and 19.3 percent of the RYGB and LAGB groups, respectively.
"The present data lead to several important conclusions: that advanced type 2 diabetes is amenable to remission by bariatric surgery, that many of those who do not achieve remission no longer require insulin postoperatively and that that RYGB appears to be superior to LAGB for its ability to improve metabolic parameters in this patient subset," write the authors.
Research: Insulin Cessation and Diabetes Remission After Bariatric Surgery in Insulin-Treated Type 2 Diabetic Adults, Ali Ardestani, David Rhoads and Ali Tavakkoli, Diabetes Care, doi: 10.2337/dc14-1751, published 8 January 2015.