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Bypass Surgery Helps Improve Diabetes Control

Gastric bypass surgery improves glycemic control levels and significantly reduces weight…. 

Researchers followed up weight-loss surgery patients one year later to find out which procedure was the most effective. Of the patients, 1,364 of 1,792 obese patients had received a Roux-en-Y bypass; 264 had a sleeve gastrectomy; and 164 had adjustable gastric banding. About one-third of each group had type 2 diabetes. At baseline, the mean HbA1c was more than 7%.

A year after surgery, patients with diabetes who had bypass surgery lost a mean of 71% of their excess body weight. Only a mean of 38% was lost in the banding group and 50% in the sleeve group. Patients in the bypass surgery group showed a higher change in their HbA1c compared to the other two groups. Also, the fasting insulin levels and blood glucose improved significantly more in the bypass surgery group.

Dr. Morton concluded that obese patients with severe diabetes should be approached with bypass surgery as a first option. "At the end of the day, though, what’s important is that the obese patient with diabetes gets treatment. All three surgeries demonstrated some improvement, and I believe that any surgery is better than no surgery at all."

Practice Pearls: 
  • Diabetics lost a mean of 71% of their excess body weight.
  • Fasting insulin and blood glucose levels improved significantly.
  • Fasting insulin is an independent marker of cardiac risk.

Internal Medicine News Oct. 2013