Some Patients Cured of Diabetes After Bariatric Surgery
Q. Dear Dr. Baskett: I have heard that bariatric surgery can cure diabetes; is that true?
A. Yes, that is true for some patients. Bariatric or metabolic surgery can bring about resolution of Type 2 diabetes even in patients who are not morbidly obese. Let me tell you about the STAMPEDE study.
The Surgical Therapy and Medications Potentially Eradicate Diabetes Efficiently study compared the effectiveness of medical therapy alone with intensive medical therapy combined with two different bariatric surgeries. Of the 150 patients in the study, 50 would be treated with medical therapies such as diet, exercise and medication. The remaining 100 patients were split into two groups, with half undergoing gastric sleeve surgery and the remaining half undergoing a gastric bypass.
Each of the 150 patients who participated in the study had Type 2 diabetes and were overweight or obese (BMI of 27 to 42). They were followed for a one-year time period.
After 12 months, the researchers measured the blood glucose levels for each patient. The goal was to have a normal glucose reading of below 6 percent, which would indicate that the diabetes had been resolved.
They found that among the three groups, just 12 percent of the patients treated with medical therapies alone achieved a blood glucose level less than 6 percent. This compares with 37 percent of the gastric sleeve patients and 42 percent of the gastric bypass patients achieving this goal.
As you can see, there was a significant difference in the patients that had undergone bariatric surgery. These results continued to be in place even two years after the surgeries for those patients who underwent gastric bypass surgery.
Why? Because of the nature of gastric bypass surgery, GLP (glucagon like peptide) is affected. This hormone plays a significant role in blood sugar and insulin regulation. For many patients with Type 2 diabetes who have this surgery, there is normalization of their blood sugars within 48 hours of the surgery — independent of weight loss.
The STAMPEDE trial demonstrates that bariatric or metabolic surgery is a legitimate treatment for patients with Type 2 diabetes. This surgery is just not about weight loss but also improvement or resolution of Type 2 diabetes and other chronic disease.
Kathleen Baskett, MD is the Medical Director of Weight Management at St. Vincent Healthcare. She is a graduate of the University of Maryland School of Medicine, and the author of “Moving Forward: The Weigh to a Healthier Weight”.