In a substudy of the STAMPEDE trial (Surgical Therapy And Medications Potentially Eradicate Diabetes Efficiently), Cleveland Clinic researchers have found that gastric bypass surgery reverses diabetes by uniquely restoring pancreatic function in moderately obese patients with uncontrolled type 2 diabetes.
The two-year substudy evaluated the effects of bariatric surgery and intensive medical therapy on blood sugar levels, body composition, and pancreatic beta-cell function. Striking metabolic changes were observed in patients who underwent bariatric surgery compared with intensive medical therapy, particularly in the gastric bypass treatment group.
"The substudy results extend the findings from our initial 12-month report that showed bariatric surgery can eliminate the need for diabetes medications in many obese patients with uncontrolled diabetes," said lead investigator Sangeeta Kashyap, M.D., an endocrinologist at Cleveland Clinic's Endocrinology & Metabolism Institute. "Furthermore, we observed that gastric bypass can resurrect a failing pancreas."
The cells of the pancreas that produce insulin, a hormone that helps the body store and use sugar, are called beta cells. Malfunctioning pancreatic beta cells can cause the pancreas to not release enough insulin; they can also produce insulin that the body does not recognize. When the body can't use insulin properly, it can't regulate the amount of glucose in its bloodstream.
"Gastric bypass surgery seems to uniquely restore pancreatic beta-cell function, presumably by targeting belly fat and modifying the hormones in the gastrointestinal tract," said Kashyap. "Gastric bypass remarkably targets belly fat where hormones that are toxic to the body develop."
Researchers observed that patients who underwent gastric bypass saw a greater reduction in belly fat compared to the patients who underwent sleeve gastrectomy. The substudy results indicate a correlation between a decrease in belly fat and the ability of the pancreas to start working again.
Diabetes Care published the study results online today.