Gastric bypass surgery keeps type 2 diabetes in remission even after weight is regained

According to a Mayo Clinic study, gastric bypass surgery for people with type 2 diabetes results in permanent remission of the disease, even after weight is regained. the study, today, Journal of the American College of Surgeonsfound that gastric bypass patients were five times more likely to have diabetes relapse compared to patients who underwent sleeve gastrectomy, but were less likely to remain in remission after five years even after gaining weight back. It shows that it is high.

Gastric bypass surgery bypasses a part of the small intestine called the duodenum, while sleeve gastrectomy is a less invasive and more popular surgery that limits the amount of food you can take in by making your stomach smaller.

Omar M. Ghanem, M.D., a bariatric and metabolic surgeon at the Mayo Clinic and lead author of the study, said, “In patients undergoing bariatric surgery, bypassing the duodenum has greater benefit for diabetic patients. “I showed that,” he said. “Patients who undergo sleeve gastrectomy and experience weight recurrence are much more likely to experience diabetes recurrence compared to patients who undergo gastric bypass, even after adjusting for all diabetic factors. I understand that.”

Dr. Ghanem pointed out that the duodenum helps regulate the so-called “intestinal metabolic pathway,” which by-passing the duodenum contributes to many physiological actions and metabolic changes, including the regulation of blood sugar.

For this study, the Mayo Clinic team looked at the rate of diabetes recurrence in patients who regained weight after bariatric surgery. The study included 224 patients who underwent gastric bypass surgery and 46 control patients who underwent sleeve gastrectomy. Patients underwent any surgery between 2008 and 2017, and all patients included in this analysis were obese and previously diagnosed with type 2 diabetes. Patients were followed for five years, at which point they were divided into four different weight classes to see who had relapsed diabetes.

Across the group, 75% of gastric bypass patients maintained diabetes remission, compared with 34.8% of patients who underwent sleeve gastrectomy. After adjusting for patient weight-related factors, the group who underwent sleeve gastrectomy was 5.5 times more likely to have diabetes relapse compared to the group who underwent gastric bypass surgery.

We stratified gastric bypass patients into four categories: patients who initially lost weight and then regained 25%, 25% to 50%, 50% to 75%, or 75% or more of their weight. More than half of all patients were defined as having regained weight. Diabetes remained in remission. Interestingly, among patients who regained more than 100% of their weight after gastric bypass, approximately 60% remained in diabetic remission, whereas in the sleeve gastrectomy group, fewer patients who regained this weight remained in remission. There were no people.

Factors associated with diabetes recurrence include elevated preoperative blood glucose levels (A1c) and prolonged preoperative diabetes duration.

Although the findings of this study are limited by the fact that it is a retrospective study and may not apply to other obesity programs, researchers look forward to better understanding the cellular mechanisms that contribute to type 2 maintenance. He said he plans to conduct more detailed research. Remission of diabetes. Having this information is important for patients when making treatment decisions.

“The key determining factor in choosing the most appropriate surgery is whether the patient wants to eliminate diabetes or minimize the chance of diabetes returning in the long term,” Ghanem says. he concluded. “Both surgeries are good, but we currently know that gastric bypass is the better surgery for people with diabetes.”