Can Gastric Bypass Surgery Put Diabetes in Remission?

By ACSH Staff — Mar 25, 2016
For the very overweight and the obese, gastric bypass surgery has essentially become a game-changer, and in some cases, a life-saver. While the operation has enjoyed this type of widespread success for the very obese, is it also reasonable to use it for those with lesser degrees of obesity? A new, small study says yes.
shutterstock_331735961 Gastric Bypass via Shutterstock

For the very overweight and the obese who have chosen this course of action, gastric bypass surgery has essentially become a game-changer, and in some cases, a life-saver because of the massive weight loss that can result. While the operation has enjoyed this type of widespread success, it can also be perceived as a cure for other related ills.

To that point, data has been accumulating that the drastic procedure can also put Type 2 diabetes in remission. And according to a news report from Los Angeles, because of this alleged benefit gastric bypass surgery is becoming increasingly acceptable for individuals considered just moderately obese.

The news item reported that researchers from Seattle assigned 32 moderately obese subjects (BMI between 30 and 45)  into one of two groups: (1) a gastric bypass group, and (2) a lifestyle modification group.

The purpose was to assess the effects each intervention had on the individuals' fasting blood sugar, insulin levels and insulin sensitivity, among other biomarkers. Results showed that nine out of 15 subjects in Group 1 saw their diabetic symptoms all but disappear. Just one person in Group 2 — which utilized diet, exercise and medication — was relieved of symptoms.

"The new thinking is might we begin to see surgery as a way to treat diabetes primarily,"

said lead author Dr. David E. Cummings of the University of Washington.

Some words of caution: Before we encourage everyone with an elevated HbA1c to jump into the gastric-bypass-pool, let's consider a few things (in addition to the fact that the study had a small sample size).

There are endocrine-related benefits to gastric bypass, such as improved cholesterol levels, decreased blood pressure and improved glucose and insulin levels irrespective of weight loss. But these same benefits also come with diet and exercise, a prudent place to begin.

What's more, a rush into surgery may do more harm than good because any type of invasive procedure is not without risk. Possible complications, although not specific to gastric bypass, include harmful reactions to anesthesia, blood clots and risk of infection at the incision site.

All in all, gastric bypass for the moderately obese could be conceived as a risky short cut to a problem that can be resolved through diet and exercise. But given the positive effects seen in this small study, as well as others, if lifestyle modification isn't enough, surgery is not an unreasonable option.