67% of gastric bypass patients were in complete remission for diabetes type 2 after 12 months, researchers from the University of Massachusetts Medical Center reported at the 29th Annual Meeting of the American Society for Metabolic & Bariatric Surgery (ASMBS). They added that 96% of those not already on insulin and who did not have lower pancreatic function went into remission after weight-loss surgery within 12 months.

Remission was less likely among those with a glucose disposition index (GDI) 30% of normal. GDI can tell the doctor how well the pancreas is producing insulin, as well as how effectively the insulin is being used by the body to regulate the breakdown of fats and carbohydrates.

Remission rates were not affected by either the patients’ pre-surgery body weights, nor by how much weight they might have lost six weeks or twelve months after their procedures.

Remission here means the patient no longer needs medication to achieve proper control of elevated blood sugar.

Bariatric surgeon, Richard A. Perugini, MD, lead author, said:

“The study shows beta cell function, the cells in the pancreas that produce insulin, and insulin dependence, not initial weight or subsequent weight loss, are the greatest predictors of potential diabetes remission after gastric bypass. The study further confirms Type 2 diabetes becomes more difficult to manage as it progresses.”

This study involved 139 obese patients, with a body mass index (BMI) ranging from 33 to 75, aged from 48 to 57 years before bariatric surgery. They all needed medication to manage their diabetes type 2 before their operation.

Below are some of the findings from this study:

  • 36% of all bariatric surgery patients no longer required diabetic medications within two weeks of their operation
  • 57% required no diabetes medications within six months of their operation
  • 67% needed no more diabetes medications within 12 months of their operation
  • Over 96% of patients on non-insulin diabetes medication with a GDI above 30% of normal achieved remission
  • Patients’ HbA1c went from 6.9 (average) to 6.1% over the 12-month time period

Other mechanisms, apart from weight loss help gastric bypass patients control diabetes. Participants lost on average 15 BMI points and 59% of their excess weight after 12 months.

Gastric bypass surgery brings about physiological changes in people, including how gut hormones that regulate the metabolism of fats and sugars behave. According to some studies, type 2 diabetes symptoms improve significantly after weight loss surgery, even before substantial weight loss occurs.

Patients with a BMI of at last 35 who have diabetes type 2 should seriously consider bariatric surgery, says the American Diabetes Association.

There are over 20 million diabetics in the USA today, over three times as many as three decades ago, says the CDC (Centers for Disease Control and Prevention). Over half of all diabetes type 2 patients in the USA have a BMI of at least thirty – 80% of those whose BMI is greater than 35 have at least one metabolic disease. Type 2 diabetes is the seventh largest cause of death in America.

According to the National Institutes of Health, obesity is a major public health and economic threat. About 72 million people are obese nationwide, of which 18 million are morbidly obese.

Obese individuals have a 50% to 100% higher chance of dying early, compared to people with healthy bodyweights. Obese people are also much more likely to develop over 40 obesity-linked conditions and diseases, including diabetes type 2, cancer and heart disease.

US health authorities have estimated that $147 billion was spent in 2008 on obesity-related problems; over twice as much as ten years before. Experts say the yearly health bill will exceed $344 billion by 2018.

Bariatric surgery, also known as weight-loss surgery, has been demonstrated to be the most effective and longest lasting treatment for morbidly obese patients.

Approximately 200,000 Americans undergo bariatric surgery annually. Since the introduction of laparoscopic techniques – keyhole surgery – bariatric surgery has become much safer. The risk of death today is estimated to be about 0.1%, while the overall chance of developing major complications ia approximately 4%.

The word bariatrics comes from the Greek word “baros” (weight), or “barys” (heavy) and “iatros” (healer, physician).

US Navy 110511-N-CW427-002 Cmdr. Gordon Wisbach prepares to insert an endoscope through a patient's belly button before performing a natural orific
Laparoscopic (keyhole) bariatric surgery is much safer than previous weight-loss surgical procedures

Written by Christian Nordqvist