A new study presented at the 94th Annual Endocrinology Meeting in Houston shows that although gastric bypass can completely reverse type 2 diabetes in most obese patients, 21 percent of them will relapse within three to five years.
Principal investigator Yessica Ramos, M.D., an internist at the Mayo Clinic in Scottsdale, Arizona, said, “Prior to surgery, recurrence rates were largely influenced by the length of history of type 2 diabetes. The durability of type 2 diabetes remission in the diabetic population would be improved if obesity were intervened with early surgical intervention.”
Ramos and her co-workers studied the medical records of 72 obese patients with type 2 diabetes who had undergone esophagogastrectomy and gastric bypass from 2000 to 2007 and had at least 3 years of follow-up visits. The authors found that: 66 of these diabetic patients (92%) had a reversal of their disease.
However, in the 3 to 5 years following surgery, 14 of the 66 patients (21%) were found to have relapsed type 2 diabetes, as documented by blood tests or reintroduction of diabetes medication. Through 5 years of follow-up, although both groups regained similar weight, the diabetics who did not relapse initially lost more weight and maintained a lower average weight. The researchers found no significant association between high relapse rates and body mass index prior to surgery.
They did find that the longer the history of type 2 diabetes prior to surgery, the higher the likelihood of recurrence of diabetes; patients with a history of type 2 diabetes for more than five years were 3.8 times more likely to have a recurrence of type 2 diabetes than patients with a history of diabetes for less than five years before undergoing bariatric surgery.
Ramos said, “Families and patients need to understand this information to get a better idea of what to expect and to be able to make an informed decision about gastric bypass.”