Gastric Bypass May Be Temporary Fix for Type 2 Diabetes

If you are obese and have type 2 diabetes, you may have considered gastric bypass surgery as a “cure” for both conditions.  But a new study shows that Type 2 diabetes comes back in about 21% of patients within five years of losing weight following gastric bypass surgery.  The results of the study, which was conducted at the Mayo Clinic in Arizona, were presented at the 94th annual meeting of The Endocrine Society.

Type 2 diabetes is a condition that results when the body is not able to process sugar correctly. This can happen if the body cannot produce enough insulin or when the cells in the body ignore the insulin that is produced.  Insulin is necessary to help cells open up and take in sugar or glucose from the blood, which is then used a as source of energy.

Being overweight or obese can cause the cells in the body to become more resistant to insulin.  This may be because fat cells are more resistant to insulin overall than are muscle cells.  So the more fat cells in the body, the less effective insulin becomes.

Studies show that losing just 5 to 7 percent of body weight can have a significant impact on Type 2 diabetes.  Losing significant amounts of weight, such as the weight loss often accomplished by gastric bypass surgery, can result in reversal of Type 2 diabetes.  When sugar levels return to normal, patients may be able to stop taking diabetes medications and may have lowered risks of the complications of diabetes.

But if you are going to try gastric bypass as a way to get rid of diabetes, the new study indicates you may get better results if you have the surgery soon after you are diagnosed with diabetes. Yessica Ramos, MD is an internal medicine resident at Mayo Clinic in Scottsdale, Arizona and was lead author of the study.  She said, “The recurrence rate was mainly influenced by a longstanding history of Type 2 diabetes before the surgery. This suggests that early surgical intervention in the obese, diabetic population will improve the durability of remission of Type 2 diabetes.”

The study team investigated the medical records of 72 obese patients who had Type 2 diabetes.  These patients had Roux-en-Y gastric bypass performed between 2000 and 2007 and had at least three years of follow-up visits in their records.   92% (66 of the 72 patients) got rid of their diabetes as their weight went down.

However, between three and five years after surgery, Type 2 diabetes came back in 14 of those patients (21%).   The authors did not find a significant relationship between body mass index before surgery and a higher chance diabetes would come back.  But they did note that patients whose diabetes did not come back lost more weight initially and maintained a lower average weight during the first five years after surgery.

The team also noted that patients who had diabetes for a longer time before gastric bypass surgery were more likely to have diabetes symptoms return after surgery.   Patients with diabetes for longer than 5 years prior to surgery were 3.8 times more likely to have a recurrence after weight loss compared with patients who had diabetes less than five years before surgery.

Ramos said “Providers and patients need to be aware of this information, to have a better idea of the expected outcome and be able to make an informed decision about pursuing gastric bypass surgery.”

If you have questions about your weight or about gastric bypass surgery to control diabetes, talk to your healthcare provider.

Denise DeWitt is a freelance writer for Empowher.com.

Sources:

Science Daily. Type 2 Diabetes, Cured by Weight Loss Surgery, Returns in On-Fifth of Patients. Web. June 26, 2012.

http://www.sciencedaily.com/releases/2012/06/120625100924.htme

About.com: Type 2 Diabetes. Obesity and Type 2 Diabetes – Extra Weight Increases Risk. Debra Manzella, RN. June 26, 2012.

http://diabetes.about.com/od/symptomsdiagnosis/a/obesity.htm

Mayo Clinic. Gastric bypass surgery. Web. June 26, 2012.

http://www.mayoclinic.com/health/gastric-bypass/MY00825/DSECTION=why-its-done

 

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