Diabetes Remission After Gastric Bypass Not Always Permanent

Over the years, gastric bypass surgery has led to remission of type 2 diabetes in a substantial number of patients, with some studies showing the absence of any diabetes symptoms even five years after the procedure.

However, a new study on how long remission lasts after gastric bypass surgery shows that 35.1 percent of patients who experienced remission redeveloped diabetes within five years. (More than 20 percent of bypass patients experience no remission at all.)

The study, led by David E. Arterburn, MD, an associate investigator at Group Health Research Institute in Seattle, focused on 4,434 adult type 2 patients who had undergone Roux-en-Y gastric bypass surgery in the years from 1995 to 2008. Arterburn said he and his colleagues were motivated by curiosity about just how long the remissive effects of the surgery lasted.

Among the patients studied, 68.2 percent experienced complete remission of their type 2 symptoms within five years after bypass surgery. Of that group, 35.1 percent initially experienced remission but redeveloped the disease within the same five-year period. (The median duration of remission among patients experiencing it was 8.3 years.)

Arterburn said that his research group identified three possible factors leading to a reduced span of remission:1. The length of time a patient had had diabetes at the time of surgery. The longer the patient had been diabetic, the less likely the occurrence of a remission at all, or in the case of remission, the greater likelihood of a relapse.

2. Patients who were on insulin therapy at the time of surgery were more likely to relapse.

3. Patients with poor glycemic control (an A1c of 7% or more) at the time of surgery were less likely to undergo remission and more likely to relapse if they did.

Those factors, said Arterburn, show that the success of gastric bypass surgery in inducing remission may be tied to the severity of a patient’s diabetes. He concluded that gastric bypass surgery is more successful among patients who have early-stage type 2. In any case, he said, the surgery is not a cure for most type 2s.

A summary of the study is available here.