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diabetes decrement!
Weight and type 2 diabetes after Bariatric Surgery: Systematic review and Meta-analysis
- Created on::
- 2010-03-24 13:28:01
Lead Author: Henry Buchwald, MD, PhD, University of Minnesota
• Study demonstrates bariatric surgery can effectively improve (78.1%) or resolve (86.6%) Type 2 diabetes in people with morbidly obesity
• Relationship of diabetes resolution/improvement and weight loss was analyzed from 621 studies from January 1990 to April 2006 involving 135,246 patients who had laparoscopic adjustable gastric banding, gastroplasty, gastric bypass, and biliopancreatic diversion/duodenal switch o Ages ranged from 16 to 65: mean age was 40
o Mean BMI nearly 48
o 80% were female; approximately 10.5% had previous bariatric surgical procedures
o Of the overall population, 22.3% had Type 2 diabetes
• 80% of patients had resolution of diabetes in the first two years after surgery and 75% remained free of diabetes more than two years after surgery
• Postoperative insulin levels, HgA1c and fasting glucose values decreased significantly
• Total excess weight loss (EWL) for at least half of the study patients was 59% EWL at two years or more follow-up
OVERVIEW
• Published in The American Journal of Medicine in March 2009• Study demonstrates bariatric surgery can effectively improve (78.1%) or resolve (86.6%) Type 2 diabetes in people with morbidly obesity
• Relationship of diabetes resolution/improvement and weight loss was analyzed from 621 studies from January 1990 to April 2006 involving 135,246 patients who had laparoscopic adjustable gastric banding, gastroplasty, gastric bypass, and biliopancreatic diversion/duodenal switch o Ages ranged from 16 to 65: mean age was 40
o Mean BMI nearly 48
o 80% were female; approximately 10.5% had previous bariatric surgical procedures
o Of the overall population, 22.3% had Type 2 diabetes
STUDY FINDINGS
• Diabetes resolution was most pronounced for patients undergoing biliopancreatic, diversion/duodenal switch (95.1%), followed by gastric bypass (80.3%) gastroplasty (79.7%) and then gastric banding (56.7%)• 80% of patients had resolution of diabetes in the first two years after surgery and 75% remained free of diabetes more than two years after surgery
• Postoperative insulin levels, HgA1c and fasting glucose values decreased significantly
• Total excess weight loss (EWL) for at least half of the study patients was 59% EWL at two years or more follow-up
COMMENTARY
• “Findings from this study make a strong statement about the remarkable effect bariatric surgery has on the resolution of Type 2 diabetes, and could one day lead to a cure for the disease.”
• "Resolution or improvement of Type 2 diabetes appears more pronounced in procedures associated with a greater percentage of excess body weight loss that is maintained for two years or more.”
• “Clinical trials comparing surgery and medical therapies for Type 2 diabetes are urgently needed, considering that 90 % of all patients with Type 2 diabetes are overweight or obese.”
-- Henry Buchwald, MD, PhD, University of Minnesota
