Metabolic Outcomes 1 Year after Gastric Bypass Surgery in Obese People with Type 2 Diabetes

Objective: To assess metabolic outcomes in obese people with type 2 diabetes (T2D) in the first year following gastric bypass surgery. Subjects and Methods: Forty-nine obese patients with T2D who had undergone gastric bypass surgery 12 or more months previously were identified. Body weight and glycosylated haemoglobin (HbA1c) pre-operatively and 3, 6 and 12 months postoperatively, changes to glucose-lowering therapies, and blood pressure (BP) and total and high-density lipoprotein (HDL) cholesterol pre-operatively and 12 months postoperatively were recorded. The primary outcome measure was change in HbA1c; secondary outcomes included changes in BP and lipid profile. Results: The mean pre-operative body weight was 141.4 kg, the body mass index 49.4 and HbA1c 8.1%. The mean postoperative percentage of excess body weight loss at 3, 6 and 12 months was 39.0, 53.9 and 71.1 with reduction in HbA1c to 6.6, 6.2 and 5.8%, respectively (p 0.0001). Remission of diabetes (HbA1c 6.5%) occurred in 12 of 18 patients (67%) at 3 months, 20 of 27 (74%) at 6 months and 21 of 25 (84%) at 12 months; of 41 patients under glucose-lowering treatment, 26 (63%) achieved complete withdrawal of treatment and 7 (17%) had their doses reduced. The mean of differences between baseline and 12-month measurements of systolic BP was 10.5 mm Hg (p = 0.021) and the total-to-HDL cholesterol ratio 0.9 (p 0.002). Conclusion: Our study confirmed the finding of previous studies that gastric bypass surgery in obese people with T2D results in significant weight loss, and improved glycaemic, BP and lipid profiles. Bariatric surgery should be regarded as an effective therapeutic intervention in this patient population.