Gastric Bypass May Reverse Insulin Treatment in T2DM
(HealthDay News) — Roux-en-Y gastric bypass surgery (RYGB) strongly predicts insulin cessation after surgery in insulin-treated type 2 diabetes (I-T2D) patients, independent of weight loss, according to a study published online January 8 in Diabetes Care.
Ali Ardestani, M.D., from Brigham and Women's Hospital in Boston, and colleagues examined changes in insulin treatment after bariatric surgery in a cohort of 5,225 patients with I-T2D. RYGB was compared with laparoscopic adjustable gastric banding (LAGB). To control for differences in weight-loss patterns between the two types of bariatric surgery, the authors conducted a case-matched analysis.
The researchers found that 62 percent of I-T2D patients who underwent RYGB were off insulin at 12 months, compared with 34% of those who underwent LAGB (P<0.001). RYGB strongly predicted insulin cessation at one and 12 months postoperatively. The proportion of insulin cessation was significantly higher in the RYGB group than the LAGB group at three months in the case-matched analysis (P=0.03), and at all time points after RYGB, the diabetes remission rate was higher. RYGB predicted insulin therapy cessation early after surgery, in a weight-independent manner, while insulin cessation after LAGB was associated with weight loss.
"These findings support RYGB as the procedure of choice for reversing I-T2D," the authors write.