Weight Loss Surgery Reverses Diabetes

Sleeve gastrectomy for type 2 diabetes puts disease in remission

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Diabetes patients often gain better control of their disease through healthy lifestyle choices. But when diet and exercise aren't enough, weight loss surgery may do the trick, especially for obese patients.

Modified weight loss surgery may reverse type 2 diabetes, especially among patients who have had diabetes for less than 10 years.

"Ask your doctor if surgery is the right diabetes treatment for you."

Sleeve gastrectomy is a type of modified weight loss surgery, or bariatric surgery. It is a less extreme than gastric bypass surgery, the most common form of weight loss surgery. Sleeve gastrectomy reduces the amount of food that can fit in the stomach. It has been shown to reverse or improve type 2 diabetes in obese patients.

In some cases, the surgery is successful in diabetes patients who are not obese.

From their recent research, Kirtikuar Modi, MD, of Medwin Hospital in Hyderabad, India, and colleagues found that 20 out of 43 patients no longer had type 2 diabetes after undergoing sleeve gastrectomy.

The patients had sleeve gastrectomy with ileal interposition - a type of sleeve gastrectomy in which part of the small intestine is moved closer to the stomach.

At the beginning of the study, all patients had poorly controlled diabetes.

After the surgery, the 23 patients who still had diabetes needed fewer diabetes drugs or smaller doses of their drugs.

Before surgery, 30 patients had hypertension (high blood pressure). After surgery, 27 of these patients no longer had hypertension.

Patients who had diabetes for less than 10 years and a BMI (body mass index) above 27 had the best diabetes remission (reversal of disease) rates.

When the researchers only included obese patients in their analysis, remission rates jumped to 85 percent, a similar rate to that of gastric bypass surgery, says Dr. Modi.

"Modified bariatric surgery such as sleeve gastrectomy should be considered at an earlier stage of type 2 diabetes, rather than as a last resort," Dr. Modi recommends.

In the study, 17 patients who had diabetes for a longer among of time - around 15 years - received a different modification of weight loss surgery called diverted sleeve gastrectomy. This surgery redirects food away from parts of the small intestine where nutrients begin to be absorbed.

Of these 17 patients, 12 no longer had diabetes after nine months. The other five patients needed fewer blood sugar medications. The surgery also reduced high blood pressure among these patients.

"Modified bariatric surgery promises to be an effective treatment for achieving a cure of type 2 diabetes and other metabolic abnormalities like high blood pressure," Dr. Modi concludes.

These findings are to be presented at the 94th Annual Meeting of the Endocrine Society. As such, the study has yet to be assessed by a peer-reviewed academic journal.

Reviewed by: 
Review Date: 
June 24, 2012
Last Updated:
November 19, 2012