Is Surgery Cure For Diabetes?

Approximately 177 million people worldwide are diabetic and the number is fast increasing. The prevalence of diabetes is predicted to double globally from 171 million in 2000 to 366 million in 2030. Therefore, diabetes is considered an epidemic of the century.

In 2000, India had the highest of number of diabetics in the world at 31.7 million (more recent estimates puts it at 41 million) followed by China at 20.8 million and the United States at 17.7 million in second and third place respectively.  India has been called “the diabetes capital of the world,” and it is estimated that every fifth diabetic in the world is an Indian. If current trends continue, Type 2 diabetes mellitus (T2DM) or pre diabetic conditions will strike as many as half of adult Americans by the end of the decade according to the United HealthGroup Inc.

T2DM leads to many health problems including cardiovascular disease, stroke, blindness, kidney failure, neuropathy, amputations, impotency, depression, cognitive decline and mortality risk from certain forms of cancer. Premature death from T2DM is increased by as much as 80 percent and life expectancy is reduced by 12 to 14 years.

Every 10 seconds, someone in the world dies from complications associated with diabetes.

More than 90 percent of T2DM is attributable to excessive body fat. The prevalence of diabetes is 8.9 percent for the U.S. population but more than 25 percent among people with morbid obesity. Based on previous studies we know that weight loss surgery of any type can lead to remission or cure of diabetes in patients who are obese and not able to maintain good blood sugar levels. But what we did not know until now is how durable are these results after the weight loss surgery.

A study published in JAMA surgery online on July 2nd tries to answer this question. This study from University of Pittsburgh showed that obese patients with T2DM had up to 40% of patients who underwent weight loss surgery had at least partial remission (fasting glucose levels less than 125 mg/dL without any medications) of diabetes 3 years after surgery. None in the other group who did not have surgery had remission of diabetes.

Does it matter what kind of weight loss surgery? According to this study, 40% who had gastric bypass and 29% who had gastric banding had at least partial remission of diabetes 3 years after surgery.   

The main drawback of the study is that it is a small study of only 61 patients from a single hospital. We need to see large scale studies across different demographic to prove the durability of the results after weight loss surgery. But for now it is safe to say that in diabetic patients with BMI of more than 35 and who have had hard time controlling blood sugars, weight loss surgery may be an option.