Gastric Bypass for Mildly Obese People with Diabetes

People with diabetes who are mildly obese — those with a body mass index (BMI) between 30 and 35 – currently do not qualify for weight loss surgery according to the NIH guidelines, yet they make up a larger group than very obese people with diabetes. More than a quarter of people in the United States with diabetes are mildly obese. Weight loss surgery is recommended by the National Institutes of Health only for people with a BMI of 40 or greater, or above 35 for people with comorbidities such as severe diabetes. However, the findings of a new study may help justify further research into whether standard indications for gastric bypass should be expanded. The study’s key finding was that gastric bypass surgery in mildly obese patients induced diabetes remission in as much as 88 percent of the patients at 6 months post-surgery.

The study consisted of 66 mildly obese men and women with severe diabetes. All the patients had diabetes for at least 7 years and had poor glucose control despite medical therapy. Six months following gastric bypass surgery, 88% of patients were able to stop taking their diabetes medications and maintain an HbA1c level of less than 6.5%.  Another 11% of the patients were able to withdraw insulin usage and/or reduce their dosage of oral medication between just 3-14 weeks after surgery.  In addition, the predicted 10-year risk of cardiovascular disease fell after surgery, with decreases in obesity-related conditions such as coronary heart disease, stroke and hypertension. Randomized, controlled trial data are needed to confirm that the gastric bypass can be recommended in mildly obese patients with diabetes. However, these findings add to the growing research showing that weight loss surgery is highly effective in resolving diabetes.

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