Gastric Bypass Surgery and Long-Term Diabetes Remission
A new study presented at the American Society for Metabolic and Bariatric Surgery (ASMBS) 2023 Annual Scientific Meeting suggests gastric bypass surgery can lead to diabetes remission regardless of weight loss.
The study includes retrospective analysis of data from researchers from Mayo Clinic in Rochester, University of California San Francisco in Fresno, and Stony Brook University Medical Center in New York. The data was collected annually for 14 years on 815 people with diabetes and an average BMI of 45.1 who had gastric bypass surgery between 2008-2017.
Importantly, the researchers saw that while diabetes remission can occur long-term regardless of weight loss after gastric bypass surgery, they qualify this by saying diabetes remission rates were proportional to weight loss after surgery.
In other words, weight loss may not be the most important factor, but it still makes a difference in overall diabetes remission rates.
Key findings show that metabolic surgery patients were more likely to achieve full remission if there was:
- No insulin use prior to surgery
- A lesser need for diabetes medications
- A shorter duration of the disease
- A lower HbA1c at baseline
- Higher weight loss after surgery
Lead study author Dr. Omar Ghanem, a metabolic surgeon at Mayo Clinic in Rochester, MN says in a press release that the research takeaway is to maintain close monitoring and efficient management of diabetes after surgery:
“Metabolic surgery is not a magic pill, but it offers perhaps the only chance for many people to rid themselves of diabetes and its associated complications once and for all.”
Dr. Mir Ali, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA tells Healthline this particular study reaffirms the many benefits of gastric bypass.
“The metabolic change induced by the gastric bypass shows lasting benefit in the treatment of diabetes based on this study,” says Ali.
Registered dietitian and diabetes rducator Julie Cunningham tells Healthline the evidence is clear that bariatric surgery helps people with type 2 diabetes improve their blood sugars, and in some cases it may actually help patients reverse diabetes.
“Patients who are in the earlier stages of type 2 diabetes — meaning they are not yet insulin-dependent, they’ve had diabetes for fewer years, or they have HbA1c levels at the lower end of the spectrum — have a greater chance of experiencing diabetes remission,” she says.
“So people living with diabetes who qualify for the surgery based on their body size may want to explore this option sooner rather than later if the potential for diabetes remission is one of their reasons for undergoing surgery,” says Cunningham.
“Regular exercise is important for blood sugar management,” says Cunningham. “When we exercise, our bodies use the sugar in our cells and our bloodstream as a source of fuel. This helps lower blood glucose levels in the short term, and it helps with weight management in the longer term.”
How much exercise should you aim for?
A minimum of 150 minutes of cardiovascular exercise per week is recommended, says Cunningham, “but those who were not exercising before surgery should get cleared by their physician first,” she adds.
