Most studies show prevention, improvement or remission of type 2 diabetes after surgery with a relatively low rate of risk in appropriate patients. The extent of remission of Type 2 diabetes is influenced by the extent of weight loss, weight regain, duration of diabetes, the pre-surgery hypoglycaemic therapy requirements, and the choice of gastro-intestinal procedure. In addition, each patient’s commitment to modifying their diet and levels of exercise within a framework of ongoing multidisciplinary care will influence outcomes.
1.2004: According to a landmark study published in the Journal of the American Medical Association (JAMA) in 2004, Gastro-intestinal (bariatric) surgery patients showed improvements in the following metabolic conditions:
2009: The Swedish Obese Subjects study clearly demonstrated the prevention and sustained remission of Type 2 diabetes in a group of 2037 severely obese patients electing to have bariatric surgery when compared with well-matched controls at 2 and 10 years follow-up (Sjostrom L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C,Carlsson Bet al.Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004;351: 2683–2693)
2008: There is a well designed prospective randomized control trial (RCT) that compared bariatric surgery (compared laparoscopic adjustable gastric banding) to conventional diabetes therapy with a focus on weight loss by diet and exercise. After 2 years, remission of diabetes was significantly more common in those who had received surgery (73 vs. 13%) (Dixon JB et al. Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial. J Am Med Assoc 2008;299: 316–323)
2009: Cochrane review including patients with and without diabetes concluded that bariatric surgery resulted in greater weight loss than conventional treatment in obese class I (BMI>30kg⁄m2) as well as severe obesity, accompanied by improvements in co-morbidities such as Type 2 diabetes, hypertension and improvements in health-related quality of life. (Colquitt JL et al. Surgery for obesity. Cochrane Database Syst Rev2009; CD003641)
2009: A systematic review and meta-analysis of 621 studies which included approximately 135 000 patients identified 103 studies reporting on the remission of the clinical and⁄or laboratory manifestations of diabetes. Overall, 78.1% of patients had ‘remission’ of diabetes following surgery. Among patients with diabetes at baseline, 62% remained in remission more than 2 years after surgery. (Buchwald H et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med 2009;122: 248–256)