Rigorous Study Says Gastric Bypass Surgery Safe and Effective to Control, Even Reverse, Diabetes
by Kimberly Romo, Tucson Medical Center Communication Specialist | Jul 22, 2013, 6 a.m.
New research finds bariatric surgery not only helps people lose weight, but is also a more effective way to reduce or even reverse diabetes, compared to medication and lifestyle changes. The findings, which come from one of the most rigorous studies of its kind, could lead to changes in who qualifies for the surgery.
The yearlong study, done by the University of Minnesota, was published in the Journal of the American Medical Association and shows gastric bypass can effectively treat diabetes in patients who are considered mild to moderately obese.
“We’re finding this especially true for patients with a lower Body Mass Index, who are about 50 to 70 pounds overweight,” said Tucson Medical Center bariatric surgeon Dr. Scott Welle.
“Our overall success rate is more effective with this patient population typically because they haven’t been diabetic as long as patients who are morbidly obese.”
Gastric bypass is the most common bariatric surgery. During the procedure, the stomach is stapled to create a small pouch and attached to a lower part of the intestines. All bariatric surgeries performed at TMC are minimally invasive, and some are even done using the daVinci surgical robot.
Welle said the research corresponds with exactly what he and other bariatric surgeons have preached all along—that weight-loss surgery is an effective tool to getting diabetes under control and even having it go into remission.
“It’s a lot more common for people to come into my office saying they want to get off their diabetes medicine rather than wanting to lose the weight,” Welle said. “Losing the weight is just the bonus.”
Type 2 diabetes affects more than 20 million Americans. Most of these patients are overweight or obese, and are at a higher risk for heart disease and stroke, among other things. Diabetes that is not controlled properly can damage the kidneys, eyes and blood vessels.
During the study, 22 out of the 60 patients in the surgery group experienced a complication. In the nonsurgical group, 15 of those 60 people also had a complication. No deaths were reported.
“When we say bariatric surgery is safe and effective, it truly is,” Welle said. “When you see high complication rates like this in a study, you need to really delve in and look at how strict they’re classifying their complications.”
Patients in the surgery group ended up using an average of three fewer medications than patients in the nonsurgical group.
“That’s medications for diabetes, high blood pressure and high cholesterol,” Welle explained.
“It’s not just diabetes, rather the gamut of the metabolic syndrome that can be treated effectively with bariatric surgery.”
The amount of time from the consultation to the actual surgery day can range from two to eight months. The pre-op workup is intense and includes a pre-authorization, pre-screening process, psychological evaluation and nutritional counseling. The surgery requires a one- to two-day hospital stay, and oftentimes patients are off their diabetes medication by the time they are discharged.
“Yes, it happens that quickly with metabolic procedures like gastric bypass,” Welle said. “A majority of my patients leave the hospital off their diabetes medication.”
Most patients resume their normal lifestyle in one to two weeks.
Since 2011, TMC has been a Bariatric Center of Excellence, an accreditation from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. For more information about TMC’s bariatric program, visit www.tmcaz.com.