VIDEO: Insulin therapy unnecessary more than 5 years after bariatric surgery
WASHINGTON — In this video exclusive, Ali Aminian, MD, associate professor of surgery at the Cleveland Clinic Lerner College of Medicine, reports long-term benefits of bariatric surgery for patients with type 2 diabetes taking insulin.
Aminian and colleagues followed 252 patients with type 2 diabetes requiring insulin therapy for 5 to 12 years (median 7 years) following Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy procedures. At the longest follow-up time, 44% of the patients were at their glycemic target without insulin therapy.
Both procedures were effective for weight loss. Initially, RYGB resulted in greater glycemic control, but the results were comparable between the procedures over time, Aminian said. On multivariate analysis, independent predictors of glycemic control included disease duration before surgery and baseline glycemic control.
“Both procedures ... can induce significant and sustainable improvement in cardiometabolic risk factors, including blood pressure and lipid profile and glycemic control, in patients with type 2 diabetes who were on insulin at the time of surgery,” Aminian said.