Almost three quarters of type 2 diabetes patients enter remission after gastric bypass surgery
In an effort to better understand the effects of bariatric, or gastric bypass, surgery on type 2 diabetes, a new study has tracked the real-world experiences of over 1,000 patients to reveal 70 percent experience diabetes remission after the procedure, and remain disease free for up to five years.
For some time now gastric bypass surgery has been a widely used surgical procedure for treating patients suffering from morbid obesity. It has also been known that the procedure results in extraordinary remission rates for patients suffering from type 2 diabetes. In some studies up to 90 percent of patients have reported entering diabetic remission following the procedure.
However, it is still unclear exactly what the long-term diabetic remission rates are in relation to the surgery, and what predictive markers can indicate the likelihood of the procedure being successful. A new study tracked 1,111 subjects with type 2 diabetes following Roux-en-Y gastric bypass surgery (RYGB) in the hopes of answering some of these questions.
The research revealed remission rates held impressively strong across the five-year follow up period. Around three quarters of the subjects achieved diabetic remission within 12 months of the surgical procedure, with 70 percent still disease-free up to five years later.
The strongest predictors of the procedure not working appeared to be whether the patient's diabetes had progressed to the point that they required insulin to manage the disease. Age also played a major role in whether the surgery effectively led to remission, with those subjects over 60 displaying reduced remission rates compared to those subjects under 40.
"The findings from this study add to the growing body of evidence on effects of bariatric surgery, specifying that RYGB does cause remission of type 2 diabetes and is associated with a reduced risk of microvascular, and possibly macrovascular complications," the researchers write. "Predictors of remission success seem to be very consistent in randomized controlled trials, studies of selected cohorts and population-based studies."
One of the big limitations in this research is a lack of individual body mass index (BMI) data. It is increasingly understood that weight management can be an incredibly effective way to treat type 2 diabetes, as in many cases a healthy diet can push the disease into remission. So, without effective BMI data it is difficult to understand whether the surgical procedure is working in any way other than helping the patient lose weight, which has obvious downstream effects on diabetes.
It has been hypothesized that gastric bypass surgery can reverse type 2 diabetes due to pushing the body's digestion processes further into the intestine, which can fundamentally alter how the body absorbs nutrients, and improve glucose homeostasis. But, the risks that come with such a major surgical procedure are not irrelevant, so if diet can effectively manage the disease then it certainly would be a preferable option.
The new study was published in the journal Diabetologia.