Studies: By Surgery or Diet, Weight Loss Helps Reverse Type 2

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In two new studies, researchers offer evidence that weight-loss surgery or a severely restricted-calorie diet could help some people reverse their diabetes.

In one study, a meta-analysis in the journal Archives of Surgery, researchers from the Netherlands looked at data on 424 people with Type 2 diabetes who received gastric-bypass surgery for weight loss and 211 people who received gastric banding surgery.

Gastric bypass involves stapling off a small pouch of the stomach and connecting it to a lower section of the small intestine; that forces food to bypass most of the stomach and part of the small intestine, reducing absorption. Gastric banding involves placing an adjustable band around the stomach that squeezes it to a smaller size.

In their analysis, the researchers found that 83% of gastric bypass patients and 62% of the banding patients were able to stop taking medication for their diabetes within a few days of surgery. Even at one- and two-year follow ups, those patients remained off medication. However, for many, the diabetes reversal was short-lived. By the 10-year follow up, only 36% of all patients were able to maintain normal blood glucose levels without medicine.

With both types of bariatric surgery, patients who lost weight more weight were more likely to experience reversal of Type 2 diabetes; therefore, the authors said it may be better for severely obese diabetes patients who have chosen surgery to have the procedure early in the course of disease.

Patients who had been able to control their diabetes through diet — rather than through drugs — and those who had been more recently diagnosed (within five years) were also more likely to see remission of disease, the data showed.

In a separate study in the journal Diabetologia, researchers from Newcastle University report that a nonsurgical method appeared to reverse Type 2 diabetes in recently diagnosed patients. The short-term, small study — with only 11 patients — found that adhering to a severely restricted 600-calorie-per-day diet of liquid meals and non-starchy vegetables lowered patients pre-breakfast blood sugar levels back to normal within seven days.

At the end of a week, MRI scans also revealed that fat levels in pancreas in the participants had dropped from about 8%, which is high, to a healthier 6%, leading to normal insulin secretion and better blood sugar levels after meals. The patients stayed on the diet for two months; three months after completing it, seven of the 11 patients were still free of diabetes, likely due to sustained lifestyle changes such as continuing weight loss and increased exercise. MRI scans at the

The BBC reported:

Keith Frayn, professor of human metabolism at the University of Oxford, said the Newcastle study was important. “People who lose large amounts of weight following surgery to alter their stomach size or the plumbing of their intestines often lose their diabetes and no longer need treatment.

“This study shows that a period of marked weight loss can produce the same reversal of Type 2 diabetes.It offers great hope for many people with diabetes, although it must be said that not everyone will find it possible to stick to the extremely low-calorie diet used in this study.”

Indeed, anyone who has ever tried dieting knows that attempting to stick to 600 calories a day for any sustained period is nearly impossible. For their part, the study’s authors don’t recommend that people try it. “This diet was only used to test the hypothesis that if people lose substantial weight they will lose their diabetes,” study author Prof. Roy Taylor told the BBC.

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