Bariatric surgery can reverse type 2 diabetes for more than 5 years in some obese patients who have the condition, according to new research.
The study, published online today in the Annals of Surgery, followed up 217 obese patients with type 2 diabetes for a median of 6 years after they had bariatric surgery. Patients had 1 of 3 bariatric procedures: 162 had Roux-en-Y gastric bypass surgery, in which the size of the stomach is permanently reduced; 32 had gastric banding, which uses an adjustable band to narrow the opening from the esophagus to the stomach; and 23 had sleeve gastrectomy, in which much of the stomach is removed.
Overall, patients lost 55% of their excess weight and half of the patients had a complete or partial remission of their diabetes after the median 6-year follow-up period. Specifically, 24% of patients had a complete remission of their diabetes with a blood sugar level of less than 6% without diabetes medications. The American Diabetes Association (ADA) recommends a blood sugar level no higher than 7%.
An additional 26% of patients had a partial remission of their diabetes, and 34% had improved glycemic control. Cardiovascular risk factors decreased by 25%. Diabetic neuropathy improved in 53% of patients and stabilized in 47%.
The investigators also found that patients who had long-term weight loss, were diagnosed with diabetes less than 5 years before their surgery, and had gastric bypass surgery rather than the other 2 procedures were most likely to have sustained diabetes remission.
However, 19% of patients who achieved full or partial remission had a recurrence of their diabetes. Even so, those patients had improved glycemic control and cardiovascular risk factors compared with their status before surgery. The investigators noted that 75% of patients who had a recurrence still met the ADA goal of blood sugar levels less than 7%.
“Only about half of diabetics in the United States currently have acceptable control of their blood glucose level,” lead investigator Stacy Brethauer, MD, a bariatric surgeon at the Cleveland Clinic Bariatric and Metabolic Institute, said in a statement. “This study confirms that [Roux-en-Y gastric bypass surgery] can offer durable remission of diabetes in some patients and should be considered as an earlier treatment option for patients with uncontrolled diabetes.”