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Diabetes health centre

Can stomach surgery cure diabetes?

BMJ Group News

Surgery to shrink the stomach can resolve the symptoms of diabetes in nearly eight out of ten patients who have it, according to a major new review of the research.

What do we know already?

If you have diabetes, you have too much glucose in your blood. The most common form is type 2 diabetes, which tends to affect people later in life (usually after age 40) and is often tied to being very overweight (obese). Losing weight can greatly improve the symptoms of type 2 diabetes, but many people have difficulty slimming down with diet and exercise alone.

Surgery to make the stomach smaller, called bariatric surgery, is a weight-loss option for some people who are very obese. With a smaller stomach, you feel full after eating less food (as little as a few ounces), so you don't eat as much and you lose weight. There are four main types of this surgery.

  • Gastric bypass: This operation usually uses staples to make a small pouch in the top part of your stomach. Your intestines are joined to this pouch. The rest of your stomach is closed off.
  • Gastroplasty: This is similar to a bypass, but the pouch isn't totally closed off from the rest of your stomach.
  • Gastric banding: An adjustable band makes a small pouch in the top part of your stomach. The band is made tighter or looser to change the size of the pouch.
  • Biliopancreatic diversion: The bottom part of your stomach is removed so your stomach is smaller.

In the past, studies have found that these operations can help people with type 2 diabetes lose lots of weight and improve their health. Researchers have now pooled the results of all the studies to find out for certain how far surgery can help. This type of research is called a meta-analysis.

What does the new study say?

The researchers looked at 621 studies with more than 135,000 patients. When the researchers combined the results of the studies, they found that:

  • People with diabetes lost an average of 64.4 percent of their excess body weight after surgery. The average weight loss was 40.6 kg (89.3 pounds).
  • Just over 78 percent were completely free of diabetes symptoms after surgery. This meant that they no longer needed to take any diabetes medicine, and their glucose levels were normal.
  • Nearly 87 percent were either free of symptoms or had some improvement.
  • Biliopancreatic diversion was the type of operation that seemed to work best, with just over 95 percent of people who had this surgery becoming free of diabetes symptoms.

However, the researchers weren't able to draw any conclusions on how common adverse effects were after surgery, as the studies didn't provide enough good information.

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