Weight-loss surgery lowers blood sugar levels in morbidly obese diabetes patients better than traditional medications such as insulin, a new study says.
Researchers from Gundersen Lutheran Medical Center in La Crosse, Wis., found that blood sugar levels returned to normal in diabetics who had laparoscopic bypass surgery. Patients who were simply given medication actually saw a rise in their blood sugar levels.
After one year, only 22 per cent of patients who had the surgery needed oral medications, such as insulin. In contrast, 82 per cent of patients who were on conventional treatments needed medication, compared to 67 per cent a year earlier.
The findings were presented at the American Society for Metabolic & Bariatric Surgery's annual meeting in Washington, D.C.
When performing laparoscopic bypass surgery, doctors shrink the size of the stomach so it can hold less food and create a channel so food can bypass the parts of the intestine responsible for absorbing calories.
The research team studied 102 diabetes patients who had an average Body Mass Index (BMI) of 47. A BMI over 30 is considered obese and a BMI over 35 is very obese.
Abstract:
Impact of Laparoscopic Roux-en-Y Gastric Bypass on HgBA1c concentrations in patients with Diabetes: a matched cohort analysis
Daniel E. Mumme, MD, Michelle A. Mathiason, MS, Kara J. Kallies, BA, Shanu N. Kothari, MD
Objective:
Elevated HgbA1c concentrations are known to increase risk of diabetic retinopathy, nephropathy, and peripheral neuropathy. Guidelines recommend maintaining HgbA1c below 7%. We compared HgbA1c concentrations in laparoscopic gastric bypass (LGB) patients who had diabetes with those of a conventionally treated cohort of morbidly obese diabetes patients.
Methods:
Through retrospective review of a prospective database, we identified a cohort of patients with diabetes who underwent LGB from 2001 to 2006. For comparison, a cohort of conventionally treated diabetes patients was matched by age and sex. Only patients with a preoperative/initial and at least two postoperative/follow-up HgbA1c tests were included. Statistical analysis was performed using paired t tests.
Results:
Each cohort had 40 women (78%) and 11 men (22%). Mean age was 49 锟� 8 years for both cohorts. Mean body mass index was 47.7 锟� 5.7 kg/m2 at surgery and 31.1 锟� 4.7 kg/m2 at postoperative year 1 for the LGB cohort, and 45.1 锟� 5.7 initially for the conventionally treated cohort.
Conclusion:
Patients who underwent LGB had significant and sustained improvement in HgbA1c concentrations compared with morbidly obese conventionally treated patients with diabetes.
