RYBG Surgery vs. Diabetes Support and Education

A progressive decline was seen in the education group despite no significant changes in weight….

Roux-en-y bypass surgery (RYBG) is a treatment option for extremely obese patients with type 2 diabetes. After RYBG, patients experience weight loss accompanied with increased insulin secretion and insulin sensitivity. RYBG is not an option for some patients due either to lack of insurance or medical complications, and they are often offered Diabetes Support and Education (DSE) with standard medical care.

The study included sixty one extremely obese participants with type 2 diabetes. Thirty participants were in a RYBG surgery group and thirty one participants were assigned to standard medical care and DSE group. Intravenous glucose tolerance test (IVGTT) was performed to measure acute insulin response to glucose (AIR) and insulin sensitivity (Si) in both groups. Body composition such as body weight, BMI, waist circumference, percent body fat, and percent trunk fat were measured in a 6 months and 12 months follow ups.

The results of the study showed a marked improvement in body composition, weight loss, glucose homeostasis, AIR, and Si after RYBG surgery. However, there was a progressive decline in glucose homeostasis, AIR, and Si despite no significant changes in body composition among the DSE group.

In conclusion, RGYB surgery proved to have a significant improvement in insulin sensitivity and weight loss for extremely obese patients with type 2 diabetes. Further studies with longer follow ups are needed to assess the long term effects of RYBG on type 2 diabetes.

Khoo C, Chen J, Pamuklar Z, et al. Effects of Roux-en-Y Gastric Bypass or Diabetes Support and Education on Insulin Sensitivity and Insulin Secretion in Morbidly Obese Patients With Type 2 Diabetes. Ann Surg. 2013 May 31