Gastric Bypass Surgery Improves Continued Type 2 Diabetes Remission, Even After Weight Recurrence

Patients who undergo gastric bypass surgery and have obesity and type 2 diabetes (T2D) are much more likely to see their diabetes in remission post-surgery compared with those who undergo sleeve gastrectomy, according to a recent study.

Researchers conducted a retrospective review of patients who underwent either gastric bypass surgery (n = 224) or sleeve gastrectomy (n = 46) to determine continued diabetes rates despite weight recurrence after surgery. The study participants underwent either procedure at Mayo Clinic between 2008 and 2017. All patients involved in the study were diagnosed with obesity and T2D prior to undergoing surgery.

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Overall, the rate of continued diabetes remission was significantly higher in the group that underwent gastric bypass (75%) compared to those that underwent sleeve gastrectomy (34.8%). Further, the study’s researchers found that the odds of T2D recurring in a patient were 5.5 times higher after sleeve gastrectomy compared to gastric bypass.

Additionally, baseline insulin use, higher preoperative HbA1c, and longer preoperative duration of T2D were associated with T2D recurrence, whereas weight recurrence was not.

“T2D remission rates after [gastric bypass surgery] are maintained despite [weight recurrence] arguing for a concurrent weight loss independent metabolic benefit likely facilitated by bypassing the proximal small intestine,” the researchers concluded.

Reference:
Ghanem O, Mosleh KA, Kerbage A, Lu L, Hage K, Dayyeh BKA. Continued diabetes remission despite weight recurrence: gastric bypass long-term metabolic benefit. J Am Coll Surg. Published online February 13, 2024. doi:10.1097/XCS.0000000000000934