Diabetes Improves After Obesity Surgery

Oct. 6, 2003 -- Gastric bypass surgery -- often a last resort for severely obese people -- can vastly improve diabetes, a new study shows.

The finding adds yet another benefit to this weight-loss procedure. Chest pain, shortness of breath, high blood pressure, and sleep problems also drop substantially, researchers have found.

However, the effects of gastric bypass surgery on diabetes have not received much attention, writes lead researcher Philip R. Schauer, MD, director of bariatric surgery at the University of Pittsburgh Medical Center. His report appears in the current issue of Annals of Surgery.

Even though diabetes is usually treated with medication and insulin, eventually it can progress to kidney failure, blindness, erectile dysfunction, even amputation, says Schauer.

'Very Dramatic' Diabetes Results

But his study showed the procedure can actually "cure" diabetes, Schauer tells WebMD. "Overall, after surgery these patients had complete resolution of diabetes -- very dramatic."

Jennifer Marks, MD, a diabetes specialist at the University of Miami School of Medicine, has counseled a number of gastric bypass patients. "Gastric surgery is a technique for people have tried everything else to lose weight and not been successful," Marks tells WebMD. "I recommend it as an option. It can work." She, too, has seen remarkable effects on diabetes.

However, if patients regain weight, "it also means their diabetes could come back," Suzanne Gebhart, MD, a diabetes expert with Emory University School of Medicine in Atlanta, tells WebMD.

All the 144 people in Schauer's study weighed over 300 pounds before gastric bypass surgery and were considered morbidly obese. Most were women with an average age of 40.

The surgery involves restricting the size of the stomach by stapling most of it shut, so that patients feel satisfied with small amounts of food. And some of the food isn't absorbed. These two mechanisms allow patients to lose weight.

The study's patients all had some degree or risk of type 2 diabetes, ranging from very mild to moderate to severe, he says. Some were taking no diabetes medications; others were taking several prescriptions plus insulin. Some patients had had diabetes for less than five years, some for more than 10 years.

Normal Blood Sugar, Fewer Meds

Schauer tracked the patients' weight loss and their diabetes during the five years after gastric bypass surgery. Overall, they lost about 60% of their body fat -- nearly 100 pounds apiece.

The women's fasting glucose levels, an indicator for diabetes, got much better:

• For 83% of the women, glucose levels returned to normal levels; for 17%, there was marked improvement.
• 80% of patients reduced the amount of diabetes medications and 79% required less insulin.

"Even patients with very severe disease, who required more than 100 units of insulin every day for more than 10 years, were cured," Schauer tells WebMD.