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Gastric bypass surgery disappoints for diabetes

Kathleen Blanchard's picture
Bariatric surgery no cure for diabetes, finds analysis

New findings show though gastric bypass reverses obesity, but the surgery is no cure for type 2 diabetes that can return, even for people who don’t regain lost weight. But that’s not to say gastric bypass didn't improve diabetes, at least temporarily, according to the analysis.

The researchers for the study found that diabetes goes away for about two-thirds of people, but returns in approximately one-third of cases within 5-years of undergoing bariatric surgery. For others, there is no remission.

According to David E. Arterburn, MD, MPH, a general internist and associate investigator at Group Health Research Institute, "Our study is the first major evidence that diabetes often recurs after gastric bypass surgery.” The finding that comes from the Group Health Research Institute highlights the importance of preventing the disease. Even with intensive lifestyle modifications, Arterburn points out outcomes for people with diabetes who are at higher risk for stroke, heart disease and deaths are disappointing; shown in the aborted Look AHEAD study

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Ongoing research
Arterburn admits diabetes is difficult to manage. Once you have the disease, it’s really difficult to reverse. But gastric bypass may have benefits that are still worth considering; including less damage to the eyes, kidneys, heart and overall mortality related to post-surgery remission that the researchers are planning on studying further. The finding also showed bariatric surgery has greater benefits for patients who have the surgery early and for diabetics whose disease is less severe. Arterburn says many people were hoping gastric bypass would be a ‘cure’ for diabetes.

The study
The study finding is based on 14-years of tracking 4,434 adults at Kaiser Permanente Northern California, Kaiser Permanente Southern California, and HealthPartners. All of the participants had type 2 diabetes, either controlled with medication or uncontrolled and obese enough to have bariatric surgery.

Diabetes rates are expected to increase with rising rates of obesity. The researchers for the current study say it’s not clear whether weight gain causes diabetes relapse after gastric bypass surgery or if there are underlying factors related to diabetes and how it progresses. The investigators failed to find a link between weight before or after gastric bypass surgery that would account for diabetes relapses.

Group Health Research Institute
November 26, 2012

Updated 12/6/2014