Guest post by Vicki Bovee, M.S., R.D., L.D., a registered dietitian with over 25 years experience in weight loss, weight management, and specializing in bariatric nutrition since 2003. www.chefdave.org
Rates of diabetes cases has tripled the past 30 years according to the Centers for Disease Control and Prevention. For many of the bariatric patients I see, the possibility of "getting rid of" their diabetes and its accompanying medications is a huge motivator.
Doctors have noticed for some time that their gastric bypass patients were experiencing remission of their diabetes, and for some patients it was before they left the hospital after their gastric bypass surgery. In a study conducted in Rome, patients who had gastric bypass surgery had a remission rate of 75%. Although it was a small study, the results are worth noting. In another study The Cleveland Clinic conducted a study comparing gastric bypass, sleeve gastrectomy, and intensive medical therapy and their effects on diabetes. Both surgeries showed remission but the gastric bypass had a slightly higher rate, and both surgeries showed far more improvement than medical therapy alone.
We know that diet and exercise alone or medications cannot produce these results. It is the changes in the anatomy from the surgery that alter gut hormones and affect the metabolism of fats and sugars. The American Diabetes Association sponsored two studies to further investigate. These studies concluded was that there is an increased amount of certain kinds of circulating amino acids (protein building blocks) that are linked to insulin resistance and cardiovascular disease. Gastric bypass surgery reduced the levels of these amino acids significantly so that remission occurred.
Is gastric bypass surgery for every diabetic? Probably not, but if one has uncontrolled type 2 diabetes and a BMI over 35, it is certainly worth investigating. Yes, one can improve diabetes control with weight loss, but not to the same extent as with gastric bypass surgery. From my personal observations of my patients, "getting rid" of their diabetes was worth the time, effort, work, and expense of the surgery and they would do it again in a heartbeat.
Vicki Bovee, MS, RD
Schauer PR, e. a. (2012). Bariatric Surgery versus Intensive Medical Therapy in Obese Patients with Diabetes. N Engl J Med366:17 .
American Diabetes Association. (2012). Changes in Amino Acid Levels Following Gastric Bypass May Improve Diabetes. www.diabetes.org/news-research