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Diabetes 'Cure' After Weight Loss Surgery Lasts Long Term

Wed, 04/10/2013 - 11:57am

Bariatric surgery may keep type 2 diabetes at bay for good, researchers found.

In a single-center study, 50% of patients whose diabetes resolved following bariatric surgery still had complete or partial remission of the disease about 6 years later, Stacy Brethauer, MD, of the Cleveland Clinic, and colleagues reported at the American Surgical Association meeting in Indianapolis.

Of those who had a complete remission, 27% met the definition of a "functional cure" of diabetes, defined by the American Diabetes Association (ADA) as a glycated hemoglobin (HbA1c) under 6% and a fasting blood glucose under 100 mg/dL that lasts longer than 5 years, Brethauer told MedPage Today.

For their study, Brethauer and colleagues assessed 217 patients with type 2 diabetes who underwent bariatric surgery at the Cleveland Clinic between 2004 and 2007. They were followed for a median of 6 years, with a range of 5 to 9 years.

The majority had gastric bypass surgery, but some patients also had gastric banding or sleeve gastrectomy.

Brethauer and colleagues found that remission -- including both partial and complete remission -- occurred in 50% of patients.

Complete remission was defined as an A1c below 6% and a fasting blood glucose under 100 mg/dL for at least a year without any medications, and 24% of patients hit this target.

Partial remission was defined as an HbA1c between 6% and 6.4% and a fasting blood glucose between 100 and 125 mg/dL for at least a full year without anti-diabetic drugs, and 26% of patients hit this target.

Brethauer noted that 27% of those who achieved a complete remission maintained it longer than 5 years, which qualified them for the ADA definition of a functional cure.

The effects were most pronounced for patients who'd had gastric bypass -- although Brethauer cautioned that selection bias could be at work because the trial was not randomized.

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