Weight-Loss Surgery Could Potentially Resolve Diabetes

Bariatric surgery to reduce obesity could completely eliminate all manifestations of Type 2 diabetes, according to a new study.

Researchers at the University of Minnesota (Minneapolis, USA) analyzed 621 studies conducted between 1990 and April 2006, which included 135,246 patients. In all, 3,188 patients reported resolution of the clinical and laboratory manifestations of type 2 diabetes. A further 19 studies with 11,175 patients reported both weight loss and diabetes resolution outcomes separately for the 4,070 diabetic patients in those studies. Clinical findings were substantiated by the laboratory parameters of serum insulin, HbA1c, and glucose. The study results showed that in all, an average of 78.1% of diabetic patients had complete resolution, and diabetes was improved or resolved in 86.6% of patients as the result of bariatric surgery. 82% of patients had resolution of the clinical and laboratory manifestations of diabetes in the first 2 years after surgery, and 62% remained free of diabetes more than 2 years after surgery (80% and 75% for the total group). The researchers observed a progressive relationship of diabetes resolution and weight loss as a function of the type of operation performed: laparoscopic adjustable gastric banding yielded 56.7% resolution, gastroplasty 79.7%, gastric bypass 80.3%, and biliopancreatic diversion/duodenal switch (BPD/DS) yielded 95.1% resolution of diabetes. After more than two years postoperative, the corresponding resolutions were 58.3%, 77.5%, 70.9%, and 95.9%. The study was published in the March 2009 issue of The American Journal of Medicine.

"This systematic review and meta-analysis demonstrate that bariatric surgery has a powerful treatment effect in morbidly obese persons with type 2 diabetes," said lead author Henry Buchwald, M.D., Ph.D., and colleagues of the department of surgery. "Randomized clinical trials comparing surgery and medical therapies for type 2 diabetes are urgently needed."

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