Roux-en-Y Surgery May Reverse Insulin Therapy in Type 2 Diabetes

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Roux-en-Y Surgery May Reverse Insulin Therapy in Type 2 Diabetes
Roux-en-Y Surgery May Reverse Insulin Therapy in Type 2 Diabetes

(HealthDay News) — Roux-en-Y gastric bypass surgery (RYGB) strongly predicts insulin cessation after surgery in insulin-treated type 2 diabetes patients, independent of weight loss, according to a study published in Diabetes Care.

Ali Ardestani, MD, from Brigham and Women's Hospital in Boston, and colleagues examined changes in insulin treatment after bariatric surgery in a cohort of 5,225 patients with insulin-treated type 2 diabetes. RYGB was compared with laparoscopic adjustable gastric banding (LAGB). 

To control for differences in weight-loss patterns between the two types of bariatric surgery, the researchers conducted a case-matched analysis.

The researchers found that 62% of insulin-treated type 2 diabetes patients who underwent RYGB were off insulin at 12 months, compared with 34% of those who underwent LAGB (P<.001). RYGB strongly predicted insulin cessation at 1 and 12 months postoperatively. 

The proportion of insulin cessation was significantly higher in the RYGB group than the LAGB group at 3 months in the case-matched analysis (P=.03), and at all time points after RYGB, the diabetes remission rate was higher. 

RYGB predicted insulin therapy cessation early after surgery, in a weight-independent manner, while insulin cessation after LAGB was associated with weight loss.

"These findings support RYGB as the procedure of choice for reversing [insulin-treated type 2 diabetes]," the researchers wrote.

Reference

  1. Ardestani et al. Diabetes Care. 2015;doi:10.2337/dc14-1751.
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