Breaking News

Early Referral for Gastric Bypass Surgery is more likely to resolve symptoms of type 2 diabetes mellitus.

June 25, 2009 (Dallas, Texas) — Early referral for gastric bypass surgery is more likely to resolve symptoms of type 2 diabetes mellitus over the long haul in patients in the early stages of the disease, according to research presented at the American Society for Metabolic and Bariatric Surgery (ASMBS) 26th Annual Meeting.

“There is a lot of information about the beneficial effects of gastric bypass [surgery] on patients with diabetes,” said James Maher, MD, professor of surgery at Virginia Commonwealth University in Richmond, and one of the study’s authors.

“It’s reported that 80% to 90% of patients have resolution of their diabetes, but there is very little information about long-term resolution of diabetes.”

Investigators looked at outcomes of 177 patients who underwent Roux-en-Y gastric bypass surgery between 1993 and 2003; minimum follow-up was at least 5 years, and was as long as 16 years for some patients!

Researchers found that complete resolution of type 2 diabetes occurred in 89.0% after surgery. There was a decrease in BMI from 50.2 to 31.3 after surgery, with a mean excess weight loss of 70.0%.

“It’s obvious that gastric bypass is very effective,” said Dr. Maher in an interview with Medscape General Surgery. “For most patients, the resolution was durable. If they had cancer, you would refer to the patients as being cured.”

“The real message to patients and to GP’s is that the earlier you refer patients for surgical therapy, the better the long-term results will be,” said Dr. Maher. “If they are referred at the stage when they are controlled by diet alone or oral medications alone, they have a good chance of being ‘cured’ of their diabetes.”

The study is significant because of the length of follow-up beyond the initial impact of gastric bypass surgery on diabetes, according to Philip Schauer, MD, past president of the ASMBS.

“We have known for quite a while that gastric bypass has a powerful immediate effect in terms of remission of diabetes, with 80% to 85% of patients having remission,” said Dr. Schauer, professor of surgery at the Cleveland Clinic Lerner College of Medicine, chief of Minimally Invasive General Surgery, and director of the Cleveland Clinic Bariatric and Metabolic Institute in Ohio. “This study shows that they are still free of their diabetes at least 5 years after surgery. It shows the impact in the long term.”

This analysis confirms the findings of other studies, that the timing of gastric bypass surgery will affect the likelihood of long-term resolution of diabetes in patients, added Dr. Schauer.

The study was independently conducted. Dr. Maher has disclosed no relevant financial relationships. Dr. Schauer receives grant funding from Ethicon Inc and from Covidien Inc.

American Society for Metabolic and Bariatric Surgery (ASMBS) 26th Annual Meeting: Abstract PL-101. Presented June 24, 2009.

Write your Comments: