Scientists have found that bariatric surgery on insulin-treated type 2 diabetics can lead to diabetes remission and insulin cessation.
The impact of bariatric surgery was evaluated by Ali Tavakkoli, MD, co-director of Centre for Weight Management and Metabolic Surgery at Brigham and Women’s Hospital, and colleagues.
Previous studies have assessed how bariatric surgery affected diabetic patients, but Tavakkoli’s team investigated the surgery on type 2 diabetics who require insulin.
Over 5,000 patients with insulin-treated type 2 diabetes were involved in the study, with weight loss determining whether they would receive Roux-en Y gastric bypass surgery (RYGB) or a laparoscopic adjustable gastric banding (LAGB).
62 per cent of patients who underwent RYGB were off insulin after 12 months, compared to 34 per cent who experienced insulin cessation following a LAGB.
Clinical remission of diabetes was identified in 50.3 per cent of the RYGB group, and 19.2 per cent in the LAGB group. The researchers concluded that insulin-dependent type 2 diabetics are more likely to not need insulin after RYGB, with weight-independent effects in the early months following surgery. Insulin cessation after LAGB was more linked to weight loss.
“The present data lead to several important conclusions: that advanced type 2 diabetes is amenable to remission by bariatric surgery, that many of those who do not achieve remission no longer require insulin postoperatively and that that RYGB appears to be superior to LAGB for its ability to improve metabolic parameters in this patient subset,” the authors wrote.
The results were published in Diabetes Care.

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