IN THE NEWS
INCREASING EVIDENCE THAT GASTRIC BYPASS BENEFITS THE LESS OBESE DIABETIC PATIENTS
Recent research study shows additional evidence that gastric bypass shows significant benefit in diabetics, even those who are less obese than the current recommendations required for bariatric surgery. The study recently reported in Diabetes Care reports the results of gastric bypass in diabetics with a body mass index between 30 and 34.9.
Bariatric surgery is currently only recommended for patients with a BMI of greater than 40 or a BMI between 35 and 40, with comorbid illnesses such as diabetes among others. This study adds to the growing body of evidence that suggests lighter patients who are diabetics also show enough benefit from the gastric bypass with their diabetes control, that they should also be offered the procedure along with the heavier patients that are now receiving the operation.
"Within 26 weeks after surgery, 88% of the patients were able to discontinue their diabetes medication and maintain a HbA1c level of less than 6.5% without resuming diabetes medications," as summarized in The American College of Surgeons, Surgery News, July 2012. An addition 11% showed improvement in their medication regimens. This proves significant advantage to the diabetic patient with regards to their overall diabetic management.
A number of theories exist about why gastric bypass affects diabetics so profoundly. Weight loss alone does improve the amount of medication that diabetics will take in general. This study however showed the benefits were not directly related to weight loss alone. Other possible causes include; the hormonal changes of the gastrointestinal system from the bypass, resulting in a change in the way the body metabolizes glucose and stimulates insulin in the pancreas.
While not currently recommended for patients with lower BMI, this new evidence adds to the growing literature that supports the benefits of gastric bypass surgery in patients with a BMI between 30 and 35. Patients who wish to undergo these procedures at the lower weights are required to be in a clinical trial, such as the one recently reported. It is hoped that in the near future this procedure will be available to all patients with mild obesity and diabetes, given its significant improvement in their diabetes management.