Study Finds Weight-Loss Surgery Soon After Diabetes Diagnosis Is Most Successful

More than half of adults with type 2 diabetes had long-term remission following gastric bypass surgery, according to a new study published in The Journal of Clinical Endocrinology & Metabolism.

Bariatric surgery helps people with severe obesity lose a lot of weight and improve their health. Two common types of bariatric surgery are lap band surgery, which places a band around the top of the stomach to create a very small pouch that can hold only a small amount of food, and gastric bypass, which reduces the size of the stomach, causes hormonal changes, and can lower the amount of nutrients that are absorbed from food. One of the biggest benefits of bariatric surgery is that it can improve or eliminate type 2 diabetes.

“If a patient with type 2 diabetes is considering weight loss surgery, choosing gastric bypass soon after diagnosis can increase their chance of remission or achieving a blood sugar level that does not need treatment,” says study author Jonathan Q. Purnell, MD, of the Oregon Health & Science University in Portland, Ore. “Our large study confirms the importance of weight loss on inducing diabetes remission, but also finds gastric bypass has benefits independent of weight. If we can understand what these benefits are, it could lead to new diabetes treatments.”

The researchers studied 2,256 adults with severe obesity (a BMI of at least 35 kg/m2) who completed annual research assessments for up to seven years after bariatric surgery, roughly 35% of whom had type 2 diabetes. Fifty seven percent of participants with diabetes achieved remission after gastric bypass surgery, and 22% reached remission after lap band surgery.

For both procedures, remission was more common in younger participants and those who had diabetes for a shorter time prior to their procedure. The researchers found a greater likelihood of diabetes remission after gastric bypass independent of weight loss, suggesting mechanisms beyond weight loss are contributing to improved blood sugar levels.

Other authors of the study include: Elizabeth N. Dewey and Bruce M. Wolfe of the Oregon Health & Science University; Blandine Laferrère of the Columbia University College of Physicians and Surgeons in New York City, N.Y.; Faith Selzer of Harvard Medical School in Boston, Mass.; David R. Flum of the University of Washington in Seattle, Wash.; James E. Mitchell of the University of North Dakota in Fargo, N.D.; Alfons Pomp of the Weill Cornell Medical College in New York, N.Y.; Walter J. Pories of the East Carolina University in Greenville, N.C.; Thomas Inge of the University of Colorado in Denver, Colo.; and Anita Courcoulas of the University of Pittsburgh in Pittsburgh, Pa.

The manuscript received funding from the National Institute of Diabetes and Digestive and Kidney Diseases and the National Institutes of Health.

The manuscript, “Diabetes Remission Status During Seven-year Follow-up of the Longitudinal Assessment of Bariatric Surgery Study,” was published online, ahead of print.

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