Surgery is becoming increasingly popular for the treatment of obesity and medically supervised weight loss, but does it impact diabetes? A new study from Italy published in the journal Surgery for Obesity and Related Diseases investigated this issue. The report is titled, “What is the impact of sleeve gastrectomy and gastric bypass on metabolic control of diabetes? A clinic-based cohort of Mediterranean diabetic patients,” and examined whether two different types of weight loss surgery can reduce diabetes in people with obesity.
The World Health Organization estimates that the rate of obesity has more than doubled since 1980, with 39% of adults worldwide being overweight and 13% obese. Surgery can be very effective for reducing the health risks associated with obesity. The American Society for Metabolic and Bariatric Surgery notes that “Surgery results in significant weight loss and helps prevent, improve or resolve more than 40 obesity-related diseases or conditions including type 2 diabetes, heart disease, obstructive sleep apnea and certain cancers.”
Sleeve gastrectomy is a surgical procedures that reduces the stomach to approximately 25% of its original size. This is accomplished by removing the more curved region of the stomach, which results in a stomach that looks like a sleeve. In gastric bypass surgery, the stomach is divided into a small upper region and a larger lower region, with a re-arranged piece of the small intestine connecting the two.
In the current study led by G. Bruno of the Department of Medical Sciences at the University of Turin, researchers studied 135 obese patients with type 2 diabetes who had either type of bariatric surgery. A total of 100 of the study participants underwent gastric bypass, and 35 had sleeve gastrectomy. They found that diabetes went into remission in 22% of all of the study subjects 1 year after surgery, and in 21.5% of subjects 2 years after surgery. Those patients with diabetes remission were typically younger, had diabetes for a shorter period of time, had lower fasting plasma glucose and a lower frequency of needed insulin treatment. Surgery improved blood pressure and increased high density lipoprotein cholesterol (“good” cholesterol).
According to the study authors, “Bariatric surgery is an effective approach to optimize glucose, lipids, and blood pressure control in obese type 2 diabetic patients. Bariatric surgery should be offered earlier over the natural course of diabetes to increase the likelihood of diabetes remission in obese patients.”
The study also suggests that some individuals are more likely to respond to weight loss surgery with diabetes remission than others. Weight loss surgery may be one way to reduce diabetes in obese individuals.