Diabetes Q&A

Diabetes Control Achieved by 44% of Bariatric Patients at 7 Years Post-Surgery

Approximately 44% of patients with severe obesity and diabetes had achieved control of their diabetes and were able to stop insulin use 7 years after receiving bariatric surgery, according to a recent study.1 Furthermore, 15% of bariatric surgery patients had achieved diabetes remission.

Findings from the study were presented at the American Society for Metabolic & Bariatric Surgery (ASMBS) Obesity Week 2017, which is taking place from October 29 to November 2, 2017, in Washington, DC.
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Metabolic and bariatric surgeries are known to be the most effective and long-lasting treatment options for severe obesity and various related conditions, and are associated with significant weight loss.

For their study, Ali Aminian, MD, associate professor of surgery at the Cleveland Clinic in Ohio, and colleagues evaluated 252 patients who had undergone either Roux-en-Y gastric bypass (n = 194) or sleeve gastrectomy (n = 58) between January 2004 and June 2012. Patients’ mean age was 52 years, and the average diabetes duration prior to surgery was 11 years. Additionally, patients had been taking insulin and had an average body mass index (BMI) of nearly 46 kg/m2 before surgery.

Results indicated that patients’ BMI had decreased by 11 points, on average. This decrease in BMI was associated with a significant decrease in blood sugar, based on hemoglobin A1c (HbA1c) levels, and fasting blood glucose.

The American Diabetes Association blood sugar target is an HbA1c of less than 7%. Prior to surgery, only 18% of patients had met this target. However, 7 years after surgery, 59% of patients had achieved an HbA1c of less than 7%.

The researchers noted that a longer diabetes duration prior to surgery was associated with less improvement after surgery. Patients who had received gastric bypass lost more body weight and used fewer diabetes medications than those who had received sleeve gastrectomy. Additionally, both surgical groups had demonstrated significant improvements in blood pressure and cholesterol levels.

“This study shows bariatric surgery can induce a significant and sustainable improvement in metabolic profile of patients with obesity and insulin-treated type 2 diabetes, typically a much more difficult group to achieve glycemic control or remission,” said Dr Aminian. “Anytime a patient can come off insulin and still have their diabetes be under control, it’s a big deal, in terms of quality of life, decreased healthcare costs, and preventing weight gain.”2

—Christina Vogt

Reference:

1. Aminian A, Hanipah ZN, Punchai S, Mackey J, Brethauer S, Schauer P. Long-term effects of bariatric surgery in patients with insulin-treated type 2 diabetes: 44% at glycemic target without insulin use (A110). Paper presented at: ASMBS Obesity Week 2017; October 29-November 2, 2017; Washington, DC. http://www.soard.org/article/S1550-7289(17)30424-0/pdf.

2. New study finds diabetes under control without insulin, 7 years after bariatric surgery [press release]. Washington, DC. American Society for Metabolic & Bariatric Surgery. Accessed November 2, 2017.