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(Best Syndication News) When compared to non-diabetics, people with diabetes lose less weight after gastric bypass surgery, according to researchers from the University of California San Francisco (UCSF). Patients with large stomach pouches also lose less weight (see videos below).

The researchers acknowledge that the surgery provides weight loss, significant improvement in quality of life, extends life span and has a low rate of complications, but 5 to 15 percent of “patients do not lose weight successfully, despite perceived precise surgical technique and regular follow-up.” The San Francisco team set out to find out why.

Roux-en-Y gastric is the most common bariatric procedure in the United State. Guilherme M. Campos, M.D. and his colleagues evaluated 361 patients who underwent gastric bypass at a local facility between 2003 and 2006.

On average they had a body mass index (BMI) of 52 before surgery. They were able to evaluate data from 310 patients after a 12-month follow-up. They found that 34 had lost an average of 60 percent of their excess body weight while 38 patients (12.3 percent) had poor weight loss.

From this data they accounted for several variables and found that patients who had diabetes and a larger pouch after surgery were more likely to have poor weight loss. Poor weight loss means losing 40 percent or less of the excess body weight after 12 months.

Why Do Diabetics Lose Less Weight After Gastric Bypass Surgery?

Diabetics may take insulin or other drugs that stimulate the production of fat and cholesterol. "Other factors that may lead to weight gain in patients with diabetes include a 'protective' increase in caloric intake to treat episodes of hypoglycemia [low blood sugar], reduction of urinary glucose losses and sodium and water retention that are a direct effect of insulin on the distal tubule in the kidney," the authors speculated.

"We conclude that gastric bypass provides good or excellent weight loss for most patients… However, diabetes mellitus and larger pouch size are independently associated with poor weight loss after gastric bypass. Changes in the use of diabetes medications may reduce the risk of poor weight loss among diabetics undergoing gastric bypass. Detailed attention to the creation of a small gastric pouch is essential for achieving the best results."

The research appears in the September issue of the Archives of Surgery, one of the JAMA/Archives journals.

Gastric Bypass Improves Diabetes Symptoms Within Days

Another study published in the September Cell Metabolism, a publication of Cell Press, describes how diabetics can control their disease by undergoing gastric bypass surgery. Lap band surgery does not offer the same benefits.

When doctors perform gastric bypass surgery they remove two thirds of the stomach and produce a "double intestine." The portion closest to the stomach is removed and does not absorb any nutrients from the food.

The lower intestine does not normally produce glucose, but when doctors place the lower small intestine in close proximity to the stomach, it can act like the upper portion which does. When the blood sugar from the intestine is absorbed into the portal vein (a large vein that carries blood from the digestive tract to the liver) it sends a signal to the brain to decrease hunger.

Diabetes symptoms improve within days by increasing insulin sensitivity and lowering blood sugar. The benefit to diabetics occurs long before weight loss. Glucose production by the intestine lowers glucose production by the liver which accounts for a much greater overall proportion of blood sugar synthesis.

Whether a diabetic person is obese or not, gastric bypass may benefit them. Gilles Mithieux of Institut National de la Sante et de la Recherche Medicale in France says patients should talk to their doctors about the possible benefits and risks of both procedures (lap band and gastric bypass). "Up to now, the intestine had been considered like a machine to assimilate nutrients. We've now begun to realize that it is a complex endocrine organ" with particular importance when it comes to glucose metabolism.

By Jeffrey Workman
Best Syndication News Writer

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