Potential of Surgery for Curing Type 2 Diabetes Mellitus

Francesco Rubino, MD, Michel Gagner, MD, FACS, FRCSC

Disclosures

Annals of Surgery. 2002;236(5) 

In This Article

Effect of Morbid Obesity Surgery on Type 2 Diabetes

GBP and BPD not only induce significant and durable weight loss but also determine amelioration or resolution of comorbid disease states, especially type 2 diabetes mellitus.[21,22,23] Sustained normal concentrations of plasma glucose, insulin, and glycosylated hemoglobin have been reported in 80% to 100% of morbidly obese diabetic patients managed surgically by GBP or BPD.[14,15,20,24] Long-term control of glycemia and normal levels of glycosylated hemoglobin have been documented in series with up to 14 years of follow-up.[24] These surgeries seems also to restore insulin sensitivity,[15,25,26] prevent the progression from impaired glucose tolerance to diabetes,[27] and reduce mortality from diabetes mellitus.[28] In the experience of Pories and Albrecht, the mortality risk from diabetes over a 10-year follow-up after gastric bypass was less than that in a cohort of diabetic patients matched for age, weight, and BMI who were not operated on (1.0% vs. 4.5% for every year of follow-up; P<.0003).[29]

There is therefore evidence enough to say that obesity surgery is an effective form of therapy for type 2 diabetes, at least in the morbidly obese.

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