Does bariatric surgery improve glycemic control in type 2 diabetes mellitus (DM)?

Updated: Sep 27, 2021
  • Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
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Kashyap and colleagues demonstrated that bariatric surgery improved glycemic control in patients with type 2 diabetes. [326] The study compared the metabolic effects of 2 types of bariatric surgery (Roux-en-Y gastric bypass or sleeve gastrectomy) combined with intensive medical therapy with intensive medical therapy alone in 60 patients with uncontrolled type 2 diabetes and moderate obesity. At 24-month follow-up, glycemic control improved in all 3 groups. Body fat reduction was similar in the 2 surgery groups, with patients in the gastric bypass group showing a greater absolute reduction in truncal fat. [326] Insulin sensitivity increased significantly only in the gastric bypass group, and pancreatic β-cell function increased significantly more in these patients compared with those in the other 2 groups. [326]

A retrospective study of 252 patients with type 2 diabetes mellitus who underwent bariatric surgery found that 44% of the patients were able to do without insulin treatment by median 7-year follow-up. The patients had a mean preoperative BMI of 46 kg/m2, with those who underwent the Roux-en-Y procedure showing a 1.4 percentage-point reduction in HbA1c at 7 years, and those who underwent sleeve gastrectomy showing a 1.6 percentage-point reduction. [327]

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