Type 2 Diabetes “Cure” After Gastric Bypass Doesn’t Necessarily Last

…according to Seattle researchers.

They looked at over 4,000 diabetics who had gastric bypass surgery for weight loss, following their cases over many subsequent years. Almost seven in 10 had a “complete diabetes remission” within five years of surgery. (Remission was defined as non-diabetic lab values on blood tests and absence of diabetic drug use.) Of those going into remission, 35% redeveloped diabetes within five years of surgery. Those with the more severe or longstanding cases of diabetes before surgery were  more likely to have a recurrence of diabetes.

bariatric surgery, Steve Parker MD

Band Gastric Bypass Surgery (not the only type of gastric bypass)

So it looks to me like, on average, gastric bypass surgery “cures” half of the cases of type 2 diabetes, as measured five years after surgery. As the years pass, even more failures will arise. Nevertheless, that’s an impressive improvement. Given the potential complications of bypass surgery, I’d try a very-low-carb diet before going under the knife. Examples are Dr. Bernstein’s Diabetes Solution and Conquer Diabetes and Prediabetes.

Steve Parker, M.D.

PS: Cure or remission of type 2 diabetes could be defined in other ways. For instance, a more reliable definition of cure might include return of normal pancreas/insulin function as judged by insulin levels and insulin sensitivity. If you have normal blood sugar levels and hemoglobin A1c, yet have ongoing insulin resistance, you’re more likely to develop overt diabetes going forward.


Filed under Bariatric Surgery

8 responses to “Type 2 Diabetes “Cure” After Gastric Bypass Doesn’t Necessarily Last

  1. frank weir

    Isn’t the remission mostly due to the change in dietary habits necessitated by the surgery? That’s my understanding. This isn’t miracle surgery that magically resuscitates the beta cells in the pancreas although bariatric surgeons might like people thinking that. After surgery, patients are largely carb intolerant and become sick if they eat the level of carbs that they used to…at least for a while, I thought. So just lower your carb intake and avoid the complications and morbidity that accompany bariatric surgery! This surgery is a growth area among medical malpractice lawyers I have read! People don’t seem to know its dangers and that relapses can occur over the years IF you survive to have them.

    • Frank, I’d love to see a head-to-head comparison of bariatric surgery and a very-low-carb diet as treatment for type 2 diabetes. They may be about equal in the short run in terms of effectiveness. The dieters would have essential zero risk of death, whereas the death risk of surgery is about 1 in 200. But since many people can’t stick with severe carb restriction for more than 2-6 months, the surviving surgery patients would probably win over the long run.

  2. Jim E

    Thank you so much for your blog. It is very informative. I need some clarification or help. You say, “….normal pancreas/insulin function as judged by insulin levels and insulin sensitivity.” Now how do I find out if I’m normal? I live in rural Kentucky/Tennessee where in the 3 to 7 minute doctor visit it’s almost impossible to have any discussion of health and the insurance codes for billing are the highest concern to the PCP (yes I’m jaded). I sure I’ll have to pay out of pocket for lab test but which test do I need?

  3. jim snell

    Dr. Parker:

    You raise important points. Reading on the work of the University of Newcastle Upon Tyne where they were doing 600 calorie extreme diets and watching those bodies on a mri spectography tools; that they would see fat get absorbed out of pancreas islets and in liver due to extreme reduced caloric input well before any observable weight loss in bell and elsewhere.

    Dr. Roy Taylor and his crew also postulate that bariatric surgery achieves similar response.

    At my local hospital that has a team doing this , I also learned that:

    After surgery, patient was put on 600 calorie liquid diet initially. I was also told it was extremely important for patient to maintain tight caloric input or risk going back to the way one started.and weight goes back on. I also understand that folks on extreme diet needed to maintain careful levels of calorie input and sufficient exercise to maintain good effects.

  4. It will be 2 years in January since my doc took me off the last of my meds. I did not have gastric bypass, I did low carb. It would be fantasy to call myself cured, so I stick with “remission” as long as I continue to eat to my meter I am in control.

    Thank you for bringing this “cure” up and the subsequent “un-cure”. So many people seriously believe it is the end all cure all, but just like low carb, it only seems to work when one works at it. (just my opinion anyways)

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