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Impact of Gastric Bypass Surgery on Post-Challenge Serum Glucose Levels

New evidence suggests surgery has glucose benefits beyond weight reduction effects…

A decrease in blood sugar values after gastric bypass surgery is associated with weight reduction. In addition to that, evidence suggests that gastric bypass surgery has affected glucose metabolism as well. The Morbid Obesity treatment, Bariatric surgery versus Intensive Lifestyle Intervention (MOBIL) study assessed the specific outcome of gastric bypass surgery on fasting and post-challenge glucose values. However, this issue has been addressed in a small amount of studies.

The purpose of this study is to analyze the outcome of weight reduction achieved by gastric bypass surgery and lifestyle intervention on one-year fasting and 2-hour glucose values. This is a post-hoc analysis of results from the MOBIL study. The trial consisted of 146 obese participants. The subjects were separated into two groups — surgical group and lifestyle intervention group. The one-year lifestyle group aimed to induce a weight reduction of at least 10% consisted of four stays at the center.

The results illustrated that the mean serum fasting and 2-hour glucose values at baseline did not vary between the gastric bypass surgery and lifestyle groups. Weight reduction after surgical treatment and lifestyle intervention was 30 (8) and 9 (10) % (p < 0.001). At one year, fasting and 2-hour glucose levels were significantly decreased in the surgery group than in the lifestyle group, 4.7 (0.4) versus 5.4 (0.7) mmol/l and 3.4 (0.8) versus 6.0 (2.4) mmol/l, respectively (both p < 0.001).

To conclude, this study exhibited that gastric bypass surgery has a clinically significant glucose-reducing effect on post-challenge glucose levels, which is seemingly not mediated through weight-loss alone. The results from the study were recorded before surgery and one year after surgery.

Practical Pearls:

  • Gastric bypass surgery and weight reduction had independent glucose-reduction effects on 2-hour glucose levels.
  • After one year, fasting and 2-hour glucose levels were significantly reduced in the surgical team.
  • Gastric bypass surgery should be recommended as a treatment for obese patients with uncontrolled glycemic control.

Hofsø D, Birkeland KI, Holst JJ, et al. “Gastric bypass surgery has a weight-loss independent effect on post-challenge serum glucose levels.” Diabetol Metab Syndr. 2015;7:69.