Gastric Bypass Surgery – The New Cure for Type 2 Diabetes

PRLog (Press Release) – Feb 28, 2008 – Bangalore: Gastric bypass surgery is the cure for a variety of people who have type 2 diabetes. For type 2 diabetes the best medicine is weight loss. Obesity is making the headlines in every obesity from overweight to morbid obesity. Both women and men are about equally represented. The world is round and so are a growing number of its inhabitants. Consider these staggering statistics. With more than 1.2 billion people in the world now officially classified as overweight, according to the World Health Organization (WHO), this is probably the most sedentary generation of people in the history of the world. India alone accounts for more than 25 million people suffering from morbid obesity.



Dr. Rajsekhar Nayak, leading Bariatric surgeon, MBBS, MS, FRCS Edinburgh UK and FRCS Glasgow UK,  Director, Nayak Institute of Gastroenterology, a division of Gunasheela Hospital, Bangalore said “But many obese people just can’t shed pounds with diet and exercise alone. The latest research shows that weight loss surgery not only helps patients to lose weight, but in many cases cures their diabetes as well. The most commonly performed bariatric surgery is known as gastric bypass surgery, where the stomach size is reduced and the small intestine re-routed to minimize calorie intake. It appears that gastric bypass surgery is the cure for a variety of people who have Type 2 diabetes. It seems that the re-routing of the food alters the way hormones are secreted from the foregut and from the pancreas and that seems to have an effect on type 2 diabetes that occurs even before people lose weight.” For further details and appointments, please contact on 080 – 6535 1256/ 98450 45758.



"People who have type 2 diabetes who are seriously overweight are good candidates for a gastric bypass," Dr. Rajsekhar Nayak observes. "Gastric bypass will have dramatic effects on their diabetes. And the sooner they have it, the better the results will be. "  



Dr. Rajsekhar Nayak points out that people can only qualify for bariatric surgery if they meet certain criteria for obesity and related health conditions: "This is major surgery, no doubt, and that comes with a variety of risks including, in a small percentage of cases, even death.”







Diabetes is emerging as a global public health problem. India tops the list  in the  prevalence of diabetes in the whole world with a burden of 35.5 million people with diabetes. The prevalence staggers around 12-15% in the urban areas and 6-8% in the rural areas. One third of persons with diabetes in the urban areas and 50% of the people in the rural areas are yet to be detected because of the asymptomatic nature of the disorder. In general, people do not go for diabetes test consciously and they are detected whenever they go for treatment for other illness. Diabetes mellitus type 2 affects more than 150 million people worldwide. Although the incidence of complications of type 2 diabetes can be reduced with tight control of hyperglycemia, current therapies do not achieve a cure. Some operations for morbid obesity not only induce significant and lasting weight loss but also lead to improvements in or resolution of comorbid disease states, especially type 2 diabetes.


Gastric bypass and biliopancreatic diversion seem to achieve control of diabetes as a primary and independent effect, not secondary to the treatment of overweight. Although controlled trials are needed to verify the effectiveness on non-obese individuals, gastric bypass surgery has the potential to change the current concepts of the pathophysiology of Type 2 diabetes and, possibly, the management of this disease. Patients with type 2 diabetes have a six fold increased risk of a first-time myocardial infarction compared with non-diabetic patients. Additionally, diabetic patients have twice the risk of myocardial infarction. As cardiovascular mortality is the leading single cause of death in India. and because patients with type 2 diabetes have a three- to eightfold increased risk of death, new treatment strategies need to be considered for this disease and its prevention.



Dr. Rajsekhar Nayak discussed a study conducted in US on 87 patients who were operated to review the effect of morbid obesity surgery on type 2 diabetes mellitus, and to analyze data that might explain the mechanisms of action of these surgeries and that could answer the question of whether surgery for morbid obesity can represent a cure for type 2 diabetes in non obese patients as well. World over it has been proved that after gastric bypass and biliopancreatic diversion achieve durable normal levels of plasma glucose, plasma insulin, and glycosylated hemoglobin in 80% to 100% of severely obese diabetic patients, usually within days after surgery. Available data show a significant change in the pattern of secretion of gastrointestinal hormones. Case reports have also documented remission of type 2 diabetes in non-morbidly obese individuals undergoing biliopancreatic diversion for other indications.



Dr. Rajsekhar Nayak describes the effects of laparoscopic gastric bypass surgery on the development of type 2 diabetes. All patients had severe obesity (BMI 35.0 kg/m2). One year after surgery, 64% patients had remission of diabetes. The prevalence of diabetes decreased from 10 to 5.6%. An additional 26% of patients with diabetes had an improvement in their control of diabetes.



While gastric bypass surgery may be hopeful for the severely obese, it must be tested prospectively in obese individuals before it can be recommended as a treatment for Type 2 diabetes. More importantly, new strategies are needed to prevent the progression of impaired fasting glucose and impaired glucose tolerance to Type 2 diabetes. Laparoscopic gastric bypass surgery may be the first to offer promise.