Over the past few years, several significant studies have demonstrated how effective bariatric surgery is at improving diabetes in obese patients. The research has been so encouraging that bariatric surgery for diabetes was named the top medical innovation of 2013. Now, researchers from the Cleveland Clinic have further pinpointed how the weight loss procedure, Roux-en-Y gastric bypass, improves uncontrolled type 2 diabetes. In a sub-study of the STAMPEDE trial (Surgical Therapy And Medications Potentially Eradicate Diabetes Efficiently), they discovered that gastric bypass reverses diabetes in moderately obese patients by uniquely restoring pancreatic function.
The cells of the pancreas that produce insulin are called beta cells. Malfunctioning pancreatic beta cells can cause the pancreas to not release enough insulin, or insulin that the body does not recognize. When the body can’t use insulin properly, it can’t regulate the amount of glucose in its bloodstream, leading to diabetes. The researchers explain that gastric bypass appears to uniquely restore pancreatic beta-cell function, seemingly by targeting belly fat—where hormones that are toxic to the body develop–and changing the hormones in the gastrointestinal tract. Patients in the STAMPEDE sub-study who had gastric bypass lost more belly fat than those who underwent gastric sleeve surgery. These findings point to a correlation between a decrease in belly fat and the ability of the pancreas to start working again.
The sub-study included 60 patients: 20 received intensive medical therapy for their diabetes, 20 had gastric bypass surgery and intensive diabetes therapy, and 20 had gastric sleeve surgery plus the therapy. The researchers found that at 2 years, 41% of the gastric bypass patients saw their blood sugar levels return to normal. Only 10% of sleeve patients and 6% of the intensive medical therapy group achieved the same results. Striking metabolic changes were observed in surgery patients compared with the intensive medical therapy patients, especially in the gastric bypass group. These findings provide substantial support for the use of gastric bypass surgery to treat diabetes in moderately obese patients.
“The Cleveland Clinic continues to lead the bariatric world by supplying us with first rate studies proving that weight loss surgery is about more than losing weight; it’s about making people healthy,” said Daniel Cottam, MD, expert bariatric surgeon in Salt Lake City. “This means treating each patient according to their metabolic problems. Many people have mistakenly decided that one procedure is best for all types of patients, however this study proves that for some patients, an intestinal bypass like the gastric bypass or the duodenal switch is vital to restoring patients health and eliminating diabetes.” Dr. Cottam advises that when patients are looking for surgeons to perform their weight loss surgery, they should look to surgeons who perform a range of procedures that can be tailored to their medical problems.
You can read more about how gastric bypass has been shown to resolve diabetes here.
Weight Loss Studies & Clinical