Bariatric Surgery and Type 2 Diabetes

Because obesity is a recognized risk factor in diabetes, it’s not surprising that some diabetes patients turn to weight-loss, or bariatric, surgery. Now a recent study has reported a surprising side effect of a type of bariatric surgery known as Roux-en-Y gastric bypass surgery (RYGB). Up to 80 percent of people who have the surgery find that their diabetes goes into remission after the procedure, and although weight loss occurs after RYGB, in many of these cases the remission occurs before a significant amount of weight is lost. Although it’s not for everyone, said Margaret A. Stefater, MD, PhD, the lead author of the study, “Bariatric surgery is the most effective option for obesity and its complications, such as Type 2 diabetes.”


The new study helps explain changes in the intestines that appear to be the reason for the early easing of diabetes in patients who’ve had RYGB. The researchers examined intestinal biopsy samples taken from RYGB patients at the time of surgery and then at 1, 6, and 12 months after. What they observed were dramatic changes in what’s known as “gene expression” in the small intestine. That is, certain genes were more likely to be “turned on,” a mechanism, the researchers said, that explains the improvement in blood glucose that takes place so soon after RYGB surgery. As Stefater put it, “This study is the first to link changes in intestinal biology to clinical improvement after bariatric surgery.” The hope now, she added, is that this new understanding of the small intestine might lead to “engineering better, perhaps nonsurgical obesity and Type 2 diabetes therapies.”

Want to learn more about bariatric surgery and Type 2 diabetes? Read “Is Bariatric Surgery for You?” and “Bariatric Surgery and Diabetes: Questions and Answers.”

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