Stomach surgery not a cure for diabetes
5 January 2012
Bariatric surgery is not a cure for type 2 diabetes, but it
can improve blood sugar control, according to a new study published in
the British Journal of Surgery. Whereas some previous studies
have claimed that up to 80% of diabetes patients have been cured
following gastric bypass surgery, researchers at Imperial College London
found that only 41% of patients achieve remission using more stringent
The research was funded by the National Institute for Health
Research (NIHR) Biomedical Research Centre awarded to Imperial
College Healthcare NHS Trust and Imperial College London.
Obesity is a major risk factor for type 2 diabetes. Worldwide,
80% of people with type 2 diabetes are overweight or obese at the
time of diagnosis. Diabetes is normally treated by using insulin
injections and drugs to control blood sugar. However, many diabetic
patients who had stomach surgery to lose weight found that their
diabetes improved, even before they had lost any weight.
Recently the American Diabetes Association pulled together a
group of experts to agree on standards by which to assess whether a
patient has achieved remission of diabetes. They defined complete
remission as returning to normal measures of glucose metabolism
without taking diabetes medication at least one year after surgery.
The new study revisited previous data on 209 patients with type 2
diabetes to evaluate the effectiveness of three types of weight loss
surgery using the new criteria. They found that the remission rate
was 41% for gastric bypass, the most effective type of surgery.
“Using the new criteria, we don’t get such eye-catching figures
as some that have been quoted in recent years,” said Dr Carel le
Roux, from the Department of Medicine at Imperial College London,
who led the study. “But it’s clear that weight loss surgery,
particularly gastric bypass, has a significant beneficial effect on
“Diabetes is a chronic, multisystem disease. Stomach surgery may
not mean that patients can stop taking diabetes medication, but
surgery and medication together achieve better results than either
treatment on its own.”
Gastric bypass involves stapling the stomach to create a small
pouch at the top, which is then connected directly to the small
intestine, bypassing most of the stomach and the duodenum (the first
part of the small intestine). Sleeve gastrectomy, which involves
surgically removing a portion of the stomach, and gastric banding,
in which a band is placed around part of the stomach, achieved
remission rates of 26% and 7% respectively, although these figures
are based on smaller numbers of patients.
DJ Pournaras et al. Effect of the definition of type
II diabetes remission in the evaluation of bariatric surgery for
metabolic disorders. British Journal of Surgery, Volume 99,
Issue 1, pages 100–103, January 2012.