Spotlight on bariatric surgery and diabetes

Several recent studies have analyzed the effects of bariatric surgery on diabetes and related complications.

A six-year study published in the July Diabetes Care followed gastric bypass procedures on women with body mass indexes of 30 to 35 kg/m² and found that 88% of them achieved diabetes remission. Another abstract presented at the annual meeting of the American Society for Metabolic & Bariatric Surgery (ASMBS) reported less weight loss after surgery in black women than white women but very similar rates of remission of diabetes in both black (75%) and white (77%) women.

Remission is less likely to be maintained after surgery in patients who have had diabetes longer, according to another study (in which patients had an average disease duration of five years) presented at the annual meeting of the Endocrine Society. Taking insulin and having reduced pancreatic function before surgery also predict a lower chance of diabetes remission after surgery, according to another abstract from the ASMBS meeting.

However, gastric bypass can eliminate or reduce the risk of nephropathy, according to other recent research. Nearly 60% of obese diabetics with nephropathy had remission of nephropathy five years after surgery, and surgical patients were 50% less likely to develop new kidney problems when compared with controls in this study also presented at ASMBS.

Finally, a summary article in The Lancet described the indications for and efficacy and safety of bariatric surgical procedures, as well as the effect on glycemic control.