Gastric Bypass Cuts Diabetes in Mild Obesity

Gastric Bypass Cuts Diabetes in Mild Obesity

Patients noticed decline in glycated hemoglobin within the first six months of surgery.

Gastric bypass may be an effective treatment for type 2 diabetes in patients who are only mildly obese, researchers said here.

The vast majority of patients (88 percent) had remission of their diabetes, bringing their glycated hemoglobin (HbA1c) to 6.5 percent, even after coming off their anti-diabetic drugs, David Cummings, MD, of the University of Washington in Seattle, and colleagues reported online in Diabetes Care and during a session at the American Diabetes Association meeting here.

An additional 11 percent achieved an HbA1c below 7 percent while decreasing their use of oral diabetic drugs and withdrawal of insulin, they found.

Gastric bypass “is a safe, effective procedure to ameliorate type 2 diabetes and associated comorbidities,” they wrote, adding that their findings justify further trials to clarify whether bypass “should be broadened and might be viewed primarily as a ‘metabolic’ rather than ‘bariatric’ surgery.”

Severely obese patients are often rid of their type 2 diabetes when they have gastric bypass surgery. An NIH consensus statement, however, limits the use of bariatric surgery to patients with a body mass index (BMI) of at least 35 kg/m2 in addition to comorbidities, the researchers said.

But patients with a BMI between 30 and 35 kg/m2 constitute the majority of obese patients, and many have diabetes. Thus, researchers have asked whether roux-en-Y gastric bypass should be offered to this population to treat type 2 diabetes.

They assessed 66 patients with a BMI of 30 to 35 kg/m2, all of whom had severe, long-standing diabetes, with a mean disease duration of 12.5 years and an HbA1c of 9.7 percent despite insulin or oral diabetes drugs.

All patients had roux-en-Y gastric bypass surgery and were followed for a median of 5 years.

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Shared from: everydayhealth