In a nutshell
This study examined the factors associated with successful reversal of type 2 diabetes following bariatric surgery. The authors concluded that greater weight loss after surgery and Roux-en-Y gastric bypass are associated with greater reversal.
Some background
Bariatric surgery involves reducing the size of the stomach in order to reduce food intake and therefore promote weight loss in obese patients with type 2 diabetes (T2D). Bariatric surgery may be carried out by placing a gastric band around the stomach (laparoscopic gastric banding – LAGB). Alternatively, the size of the stomach is reduced to a small pouch (Roux-en-Y gastric bypass – RYGB). T2D patients may enter remission (no signs or symptoms of disease) after bariatric surgery. However, whether certain factors, such as weight loss after surgery and the type of surgery, affect remission rates is still under investigation.
Methods & findings
This study aimed to determine the factors associated with greater remission of T2D after bariatric surgery.
This study involved 627 obese T2D patients. 466 patients underwent RYGBP and 140 underwent LAGB. Remission rates for T2D were assessed for up to 3 years.
After 3 years, 68.7% of patients who underwent RYGBP were in remission. In contrast, 30.2% of patients who underwent LAGB participants were in remission. Patients were two times more likely to achieve remission rates following RYGBP compared to LAGB.
Remission was greater in patients who had higher fasting C-peptide (indicates insulin production) levels and a lower HbA1c (average blood glucose levels over 3 months). Remission following LAGB was greater in patients who had a lower weight prior to surgery. Greater weight loss after either surgery was associated with remission.
The bottom line
This study concluded that diabetes remission is higher when weight loss following surgery is greater, and when RYGB is the type of surgery performed.
The fine print
The decision of when to start or stop diabetes medication (one of the measures of remission used in the study) was left to the patient and their primary care provider. Therefore, the approach to diabetes management differed across the various treatment centers.
What’s next?
Consult your physician regarding the risks and benefits of RYGB and LAGB for the reversal of diabetes.
Published By :
Diabetes Care
Date :
Jun 11, 2016
