Dear Dr. Baskett: Is it true that bariatric surgery can cure Type 2 diabetes?
Dear Reader: There is a very high correlation between obesity and Type 2 diabetes, and bariatric surgery has been shown to bring about remission of diabetes in certain patients. Let me share the final findings of a five-year research trial called STAMPEDE, which stands for Surgical Therapy And Medications Potentially Eradicate Diabetes Efficiently.
In the STAMPEDE trial, 150 obese patients with uncontrolled Type 2 diabetes were randomly placed into three different groups. In the first group, 50 people received intensive medical therapy and gastric bypass surgery. In the second group, 50 patients received intensive medical therapy and sleeve gastrectomy. In the third and final group, 50 people received intensive medical therapy only.
The results of this study showed that those in Group 1, who had intensive medical therapy combined with bariatric surgery, saw marked improvement in blood sugar control compared to medical treatment alone. The final results are important because, medically speaking, five years marks the time of being able to conclude durability; in other words, to prove that something works. In this case, the ability of bariatric surgery to improve diabetes.
Initially, it did appear that the results were the same whether the patient had gastric bypass surgery or sleeve gastrectomy. However, at the three-year mark onward, the gastric bypass patients did experience more weight loss as well as loss of more intra-abdominal fat. This is associated with improved blood sugar control.
Of patients who had gastric bypass, 35 percent maintained normal blood sugar (HbA1c < 6%) on no medications at three years, and 90 percent of surgery patients were able to be weaned off insulin completely. Many patients were also able to stop their blood pressure medications as well as lipid lowering medications due to the significant weight loss. They also had less joint issues after significant weight loss and for many, their sleep apnea was resolved. Thus, not only was health improved but also the quality of day-to-day living for those people who had bariatric surgery.
So, does bariatric surgery cause Type 2 diabetes to go away? The answer is that in some patients, yes. Type 2 diabetes can be reversed after bariatric surgery and the significant weight loss that does occur. However, this weight loss must be maintained. If weight is regained, blood sugars begin to creep up and the diabetes if present again.
That’s why it is so important to maintain regular follow-up visits after your bariatric surgery. Take your vitamins and minerals, follow the prescribed eating plan, and exercise. Bariatric surgery is not a cure for obesity or diabetes, but it is a wonderful tool. This tool, along with lifestyle change, will offer you the best opportunity to reach and maintain a healthy weight and blood sugar control.