New research reports that no procedure for weight loss surgery is any better at treating diabetes than another. The study, presented at the International Congress of Endocrinology/European Congress of Endocrinology in Florence, Italy, uses a large ongoing study to show that improvements to diabetes in patients undergoing such surgery is likely to be due to the degree of weight loss itself rather than the type of procedure.
A number of procedures for weight-loss surgery (termed ‘bariatric surgery’) have been developed which can work by reducing the functional size of the stomach (‘restriction’), reducing the capacity of the gut to absorb calories (‘malabsorption’) or by a combination of the two. The well-documented improvement in diabetes following such surgery has puzzled doctors but the evidence suggests it is due in part to the altered transit of food through the gut. It is therefore possible that different procedures would give different degrees of improvement. This is what Associate Professor Markku Peltonen at the National Institute for Health and Welfare, Finland and colleagues from the University of Gothenburg, Sweden, set out to investigate using data from the large ‘Swedish Obese Subjects’ study.
2010 severely obese patients (with BMI>34 in men and >38 in women) recruited to the study went on to receive bariatric surgery: 376 gastric banding, 265 gastric bypass (GBP), and 1369 vertical banded gastroplasty (VBG). They followed 74% of these patients at both 2 and 10 years and measured improvements in diabetes via blood glucose and insulin levels before and after surgery. The degree of weight loss was categorized as more than 30kg, 30-25kg, 25-20kg and 20-15kg. Improvements in blood glucose and insulin were then compared between the three different surgical procedures accounting for the degree of weight loss.
After 10 years, the researchers found there was no significant difference in the changes to insulin and glucose levels between the three surgical groups when the extent of their weight loss was taken into account. This was true for patients with and without diabetes at baseline. The average 10 year weight losses were 18kg, 20kg and 29kg for the banding, GBP and VBG groups respectively.
In a further analysis patients that lost the same amount of weight improved their blood glucose and insulin levels to similar degrees, regardless of the type of surgery.
The researchers conclude that the remarkable improvements in diabetes following weight loss surgery are not a direct result of the procedure itself. More research now needs to take place to investigate why bariatric surgery can cure diabetes in these patients, and why some patients respond better than others.
Associate Professor Markku Peltonen, Director of Department at the National Institute for Health and Welfare, Finland, said:
“Perhaps it is simply the act of losing weight that helps.”
Health-e-Solutions comment: It is great that bariatric surgery leading to weight loss can reverse diabetes. However, we maintain that unless their diets improve, many will eventually revert to their diabetic state. If food got them there, and we believe hat is a strong contributor, food will send them there again. The Health-e-Solutions lifestyle may be able to help keep the weight off and maintain a lifestyle that is low-glycemic and nutritious.
Our recipe e-books and home study course will teach you how to transform your lifestyle in a practical, livable way for long term sustainability and better living. You will enjoy a natural way to help manage type 1 and type 2 diabetes with healthy, natural, whole, very low-glycemic foods. While Health critically important, Outlook, Planning and Evaluation are also part of our framework of HOPE. Cultivating a lifestyle that seeks to improve these four foundational principles will take you far on the road toward a thriving life.