Weight loss via diet or gastric bypass yield similar metabolic benefits
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Insulin sensitivity and beta cell function improved among patients with type 2 diabetes after 18% body weight loss by diet or gastric bypass, according to a study presented at Digestive Disease Week.
“Significant weight loss, whether secondary to medical therapy or surgical therapy, has profound benefits in reducing diabetes. Bariatric surgery has consistently been shown to have a greater impact on type 2 diabetes,” Christopher Eagon, MD, Washington University School of Medicine, said. “In randomized and nonrandomized studies within different types of bariatric surgery, there are differences in the rate of diabetes remission differences after the surgery. ... Among type 2 diabetes patients, the extent to which the insulin axis of metabolic function may be affected by weight loss dependent vs. weight loss independent factors is unclear.”
In a non-randomized, matched cohort study, researchers analyzed patients with type 2 diabetes to measure metabolic changes after significant weight loss by diet vs. gastric bypass. Of 33 patients, 15 patients underwent gastric bypass and 18 underwent diet changes; they further underwent baseline measurements before and after 18% body weight loss.
According to study results, weight loss in the diet group and the gastric bypass group correlated with increased insulin-stimulated glucose disposal (30.5-61.6 µmol/kg of fat-free mass vs. 29.4-54.5 µmol/kg of fat-free mass, respectively). Weight loss also correlated with increased beta cell function by 1.83 units (95% CI, 1.22-2.44) in the diet group and by 1.11 units (95% CI, 0.08-2.15) in the gastric bypass group. Researchers further noted decreases in areas under the curve for 24-hour plasma glucose and insulin levels.
“After 18% weight loss by diet or gastric bypass, integrated glucose and insulin during fasting/fed states are the same, beta cell responsiveness is the same, tissue-specific internal body insulin sensitivity is the same and beta cell function is the same,” Eagon concluded. “When it comes to overall insulin sensitivity and beta cell function, it appears that weight loss can account for all the improvement in these parameters.”
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Eagon C, Presented at: Digestive Disease week; May 21-23, 2021 (virtual meeting).
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