Bariatric surgery in people with morbid obesity results in effective long-term weight loss, and resolution or reduction in the severity of several co-morbid conditions. The majority of obese people with type 2 diabetes who undergo bariatric surgery, achieve remission of their diabetes or a significant reduction of their glucose lowering therapy in the long-term. We conducted a retrospective observational study to assess changes in body weight and glycaemic control in obese type 2 diabetic patients in the first year after bariatric surgery to assess early efficacy.
Sixty-four obese type 2 diabetic patients (39 women) with a mean age of 49.5 years who had undergone bariatric surgery were identified from electronic patient records. Data recorded included preoperative and postoperative body weight and glucose control at 3, 6 and 12 months, and changes to diabetes treatment. The mean preoperative body weight was 143 kg and mean body mass index of 49.4 kg/m2. The mean duration of diabetes was 9.8 years and 53% of patients were receiving oral hypoglycaemic agents whilst 26% were on insulin with or without oral agents. The mean preoperative glycosylated haemoglobin (HbA1c) was 7.99%.
The mean postoperative weight loss at 3, 6 and 12 months was 28.1 kg (19.7%), 37.0 kg (25.9%)and 47.9 kg (33.5%) from baseline respectively, with a corresponding fall in mean HbA1c to 6.97, 6.55 and 6.15% respectively. Of those patients who were on glucose lowering treatment preoperatively, 67.5% achieved complete withdrawal of treatment whilst 32.5% had their medication dosage reduced.
This study confirms significant weight loss comparable to the results of similar studies reported in the literature. It also demonstrates early remission or improvement in type 2 diabetes following bariatric surgery. Bariatric surgery should be regarded as an effective therapeutic intervention in the management of obese people with type 2 diabetes.