diabetes and bariatric surgery

It’s clear that bariatric surgery can be a useful tool for people who need to lose 100 pounds or more: It may help you achieve long-term weight loss, reduce or eliminate life-threatening weight-related conditions, increase longevity, and improve your quality of life. But can bariatric surgery also control or even help reverse type 2 diabetes?

A Look at the Diabetes and Bariatric Research

It’s quite possible, according to some research, including studies conducted at the University of Pittsburgh Medical Center (UPMC). For instance, researchers looked at data from male and female patients at 10 different hospitals who had undergone either gastric bypass surgery or laparoscopic gastric banding. After three years, the researchers found that, of the people who had specific obesity-related health problems prior to surgery, 67 percent experienced partial remission from diabetes. These findings were published in 2013 in the Journal of the American Medical Association.

More recently, investigators at UPMC randomly assigned 61 people to one of three groups: gastric bypass surgery, laparoscopic gastric banding, or a nonsurgical intensive weight-loss program. All of the patients also followed lifestyle approaches. After three years, 40 percent of the first group and 29 percent of the second group had partial or full remission of diabetes, compared to none of those in the third group. In addition, that remission lasted at least two years in 45 percent of first group and 29 percent of the second group. This study, which was published online in JAMA Surgery, is one of just a few to look at the long-term effects of bariatric surgery on diabetes.

Bariatric Surgery and Procedure Options

There are several different types of bariatric surgery, but the two that have been best studied for their effect on diabetes are gastric bypass surgery and laparoscopic gastric banding.

What is gastric bypass surgery?

Also called the Roux-en-Y gastric bypass procedure, the former is the most common form of weight loss surgery performed in the United States today. In this surgical procedure, your surgeon will create a small pouch that bypasses the stomach and attaches to the intestine. This pouch will act as your new stomach and can only hold about one cup of food, compared to four to six cups in a normal stomach.

What is laparoscopic adjustable gastric band surgery?

Also known as adjustable gastric banding, laparoscopic gastric banding involves the insertion of a thin, inflatable ring called a gastric band to create a new, smaller stomach pouch so you feel full sooner. Unlike traditional gastric bypass surgery, lap band surgery is minimally invasive and reversible.

Both types of bariatric surgery may help control type 2 diabetes by reducing visceral fat — the kind of fat around internal organs, which contributes to problems with blood sugar. Bariatric surgery may also improve blood sugar control by altering levels of gut hormones, as well as by speeding up weight loss and encouraging you to follow lifestyle measures such as eating well and exercising regularly.

For more information on bariatric surgery, and to find out if you’re a candidate, visit the UPMC Bariatric Surgery Center of Excellence website or contact us to attend an information session.