Bariatric Surgery is Safe and Effective Treatment for Diabetes in Non-morbidly Obese Patients: Results reported by ASMBS Bariatric Surgery Centers of Excellence (BSCOE) in Bariatric Outcomes Longitudinal Database (BOLD)
*Eric J DeMaria1, *Deborah Winegar2, *Virginia Pate2, *Quinn Sanger2, Walter J Pories3
1Duke University, Durham, NC;2Surgical Review Corporation, Raleigh, NC;3East Carolina University, Greenville, NC
Small case series suggest bariatric surgery may be effective treatment for diabetes in patients who do not meet criteria for morbid obesity (BMI < 35 kg/M2), but large multi-institutional series, which allow better assessment of the safety / efficacy of treatment, have not been reported.
Data from 66,264 research-consented patients with a surgery encounter in BOLD were queried to identify patients with BMI > 30 but < 35 kg/m2 (1.2%, n=794) and diabetes (DM) requiring any medication (29% of group).
235 patients met inclusion criteria. The 2 most common procedures (adjustable gastric banding AGB, n=109 and gastric bypass, n=109) were compared. Laparoscopic access was utilized in 92% of procedures. Gender (77% female), race (80% Caucasian), and age (mean 52.6 + 10.4 yrs) did not differ between procedure groups.
Table: Data reported at baseline (BL) and at intervals < 12 months following surgery. (*p<0.05 vs. BL, α p<0.05 bypass vs. band)
Remission (cessation of medications) of DM was reported in 47.8% of patients within 6-12 months of surgery. Gastric bypass provided superior weight loss and DM remission, but demonstrated more frequent complications (90-day AE: 12% vs. 3%, p<0.05). No mortalities were reported. The data suggest successful surgical treatment of diabetes in patients not meeting criteria for morbid obesity. Gastric bypass provides more effective early treatment for DM within 6-12 months.
|n||BMI||# DM meds||% DM remission|
|0-3 mos||90||88||31.6±2.5*||30.6±3.0* α||0.96±1.11*||0.76±1.02*||21.1||37.5* α|
|3-6 mos||63||44||31.0±2.7*||27.2±3.8* α||0.76±1.04*||0.39±0.65*α||31.8*||50.0*|