A recent study published in the Journal of the American College of Surgeons sheds light on the impact of gastric bypass surgery on remission rates for type 2 diabetes in individuals with obesity. The research, conducted by scientists from the Mayo Clinic in Minnesota, revealed that even in cases of weight regain, those who underwent gastric bypass surgery were more likely to experience diabetes remission compared to those who opted for a gastric sleeve procedure.
The study involved an analysis of medical records from 224 participants who underwent gastric bypass surgery at the Mayo Clinic between 2008 and 2017, alongside records from 46 individuals who received a gastric sleeve procedure. All participants had previously been diagnosed with obesity and type 2 diabetes.
Over a monitoring period of at least five years post-surgery, the researchers explored the correlation between weight gain and diabetes recurrence. Key findings from the study include:
Gastric bypass surgery demonstrated high rates of type 2 diabetes remission even five years after the procedure, even in cases of substantial weight regain.
Participants who underwent gastric sleeve surgery were 5.5 times more likely to experience diabetes recurrence compared to those who opted for gastric bypass.
Approximately 60% of individuals who regained weight after gastric bypass surgery still maintained long-term diabetes remission, in contrast to no participants in the gastric sleeve group.
Factors such as insulin use, higher A1C levels before surgery, and a longer preoperative duration of diabetes were more strongly linked to diabetes recurrence than weight regain.
Gastric bypass surgery involves reducing the stomach’s size and rerouting the upper part of the small intestine, known as the duodenum. On the other hand, gastric sleeve surgery reduces the stomach’s size by 80% but does not alter the upper part of the small intestine, distinguishing it from gastric bypass.
Dr. Christine Ren-Fielding, the division chief of bariatric surgery at NYU Langone Health in New York, who was not involved in the study, emphasized the clinical significance of the findings. She recommended gastric bypass for individuals with diabetes mellitus due to its higher likelihood of achieving diabetes remission. However, she acknowledged that gastric sleeve surgery could be a viable alternative, especially when concerns about intestinal rerouting are present, and emphasized the potential efficacy of multimodal therapy, specifically GLP-1 agonists.
