Cut That Gut?

Gastric bypass relieves diabetes problems but often does not cure it

(RxWiki News) Opting for a smaller stomach can bring some good. For those with type II diabetes, going under the knife can bring a lot of good, almost to the point of a full cure.

New research has found that about a third of patients who were free of diabetes after having gastric bypass went back to having the condition.

But these researchers said that surgery can help patients with a number of problems linked with diabetes.

"Talk with your doctor about gastric bypass."

Severely obese patients can qualify for gastric bypass surgery, which divides the stomach into two parts and in turn helps decrease hunger and the desire for food.

Researchers, led by David Arterburn, MD, MPH, an affiliate assistant professor at the University of Washington and associate investigator at Group Health Research Institute, looked at how gastric bypass affects the chances that former diabetes patients will have it again years after surgery. The study included almost 4,500 patients who had the surgery between 1995 and 2008 at three different sites belonging to the HMO Research Network in California.

Patients had type II diabetes and qualified to have the gastric bypass surgery. About half were on some medication to treat it and the rest were not controlling their symptoms.

After having surgery, researchers found about 35 percent of the patients who became free of diabetes redeveloped it within five years. Initially, diabetes went away in more than two-thirds of the patients after having the surgery. Patients who had less severe diabetes or had it at an earlier stage were more likely to reap the benefits from surgery, according to Dr. Arterburn.

“Prevention is by far the best medicine for diabetes,” Dr. Arterburn said in a press release. “Once you have diabetes, it’s really hard to get rid of. Attempts to treat it with intensive lifestyle changes and medical management have been disappointing.”

Researchers also found that looking at a patient's blood sugar levels, insulin use and the length of time they had diabetes help predict whether they will be completely symptom free or have symptoms return.

Even if diabetes returns, the authors said, the surgery could help with the complications linked with diabetes, such as decreasing the number of strokes, damage to kidneys and eyes, and lowering heart attack risk and deaths.

“No wonder so many were excited to learn that diabetes can remit after gastric surgery—even, in some cases, before any significant weight loss—and many were hoping that gastric surgery might be a ‘cure’ for diabetes,” Dr. Arterburn said. “Our study is the first major evidence that diabetes often recurs after gastric bypass surgery.”

They say future research looking into how relapse works and the timing of the surgery is needed to optimize the number of people who are no longer diabetic.

The study was published online November 18 in the journal Obesity Surgery. The Agency for Healthcare Research and Quality and the National Institutes of Health funded the study. No conflicts of interest were reported.

Review Date: 
December 2, 2012