Best Surgeries for Diabetes

Gastric bypass and sleeve gastrectomy for obese type 2 diabetes patients may lead to long term results

/ Author:  / Reviewed by: Chris Galloway, M.D.

(RxWiki News) In study after study, weight loss surgery has reversed diabetes' impact on the body. But there are many kinds of weight loss surgery to choose from. So which ones work best?

Two types of weight loss surgery - called gastric bypass and sleeve gastrectomy - appear to be the best procedures for treating type 2 diabetes and keeping off excess weight, according to recent research.

Researchers found that 36 percent of patients who underwent gastric bypass did not need diabetes drugs 2 weeks after surgery. A year after surgery, 67 percent of patients were drug free.

"Ask your doctor if weight loss surgery is right for you."

That number jumped to over 96 percent if patients were not already taking insulin and did not have lower pancreatic function, according to the study by Richard A. Perugini, MD, of the University of Massachusetts, and colleagues.

Insulin is a natural hormone that helps the body turn sugar into energy. In people with diabetes, the body either produces little insulin or does not respond well to insulin, causing blood sugar levels to rise. For this reason, many diabetes patients take external insulin to control blood sugar.

"Gastric bypass and sleeve gastrectomy have been shown to be the most effective at ridding the body of diabetes and helping patients lose weight," said Vadim Sherman, MD, FACS, FRCSC, of the Methodist Hospital in Houston, who was not involved in the study.

"Lap band and stomach stapling don't change your metabolism the way the other two procedures do because you are basically just putting an obstruction into the abdomen to make you eat less," he said.

In gastric bypass surgery, the stomach is cut to make a pouch that is attached to the intestine. Food then goes around the old stomach, into the pouch and then into the intestine.

In sleeve gastrectomy, a portion of the stomach is cut away.

Unlike lap band and stomach stapling surgeries, gastric bypass and sleeve gastrectomy cause changes to a patient's metabolism. That is, these surgeries change the way hunger hormones work and how the body burns fat. As a result, patients absorb less food and eat less.

Even though weight loss surgery can significantly improve diabetes, patients have to do much more to really rid themselves of diabetes.

"Surgery alone is not the answer. Patients also need to make lifestyle changes in order for any weight loss surgery to work long term," said Dr. Sherman.

"That being said, the best options to get rid of diabetes and lose the weight you want to lose are gastric bypass and sleeve gastrectomy," Dr. Sherman concluded.

The study by Dr. Perugini and his fellow researchers involved 139 obese patients taking medications to control their type 2 diabetes. The research was presented at the 29th Annual Meeting of the American Society for Metabolic & Bariatric Surgery. As such, the study has yet to be reviewed by a body of peers for publication in a scientific journal.

Reviewed by: 
Review Date: 
November 29, 2012
Last Updated:
February 21, 2013