A Medical Device Daily

A new study shows that teens that have undergone bypass surgery showed a dramatic and almost sudden remission of Type 2 diabetes. The study was conducted by the Cincinnati Children's Hospital Medical Center, and the results will appear in the January issue of Pediatrics.

The Cincinnati Children's study reports that bariatric surgery, specifically Roux-en-Y gastric bypass, helped teens lose, on average, one-third of their body weight and induced remission of the diabetes in all but one teen. The study also notes other health improvements in the patients who had the surgery, such as lower blood pressure and lower cholesterol levels.

Results reflected data from 78 teenagers, weighing from 250 to 403 pounds, who suffered from Type 2 diabetes. Nearly 11 of those patients underwent gastric bypass surgery at one of five participating medical centers: Cincinnati Children's, Texas Children's Hospital (Houston) University of Florida (Gainsville) Children's Hospital of Alabama (Birmingham) and University of Pittsburgh Medical Center.

The other 67 patients in the study were part of a comparison group at Cincinnati Children's receiving routine medical management for their diabetes, but did not receive surgical treatment of any kind.

The extremely obese teens who underwent bariatric surgery had an average 34% reduction in weight one year after surgery, with all but one seeing their Type 2 diabetes go into remission.

By comparison, the obese teens in the medically managed comparison group saw their weight remain essentially the same (reduction of just 1.6%), and all of those patients were still taking medication for their diabetes.

After one year, those who had surgery had lost between 72 and 218 pounds, although none had dropped to what would be considered for them a normal weight. For 10 of them, their diabetes was in remission and they were able to stop their taking diabetes medicine.

"The results have been quite dramatic and to our knowledge, there are no other anti-diabetic therapies that result in more effective and long-term control than that seen with bariatric surgery," said Thomas Inge, MD, PhD, surgical director of the Cincinnati Children's Surgical Weight Loss Program for Teens and lead author of the study, in a statement.

So how quickly can patients start to see results?

According to the study, they can come off diabetes medications almost immediately, always by the time they leave the hospital following surgery.

"The results have been quite dramatic and to our knowledge, there are no other anti-diabetic therapies that result in more effective and long-term control than that seen with bariatric surgery," Inge said.

For the teens who didn't have surgery, they all still had diabetes after a year of follow-up and there was no difference in their weight or their use of diabetes medication. Their blood sugar levels did improve, the researchers said.

As for the one surgery patient whose diabetes wasn't reversed, the researchers said the reason wasn't known, but they noted his mother and a younger sibling also had Type 2 diabetes. Three years after the surgery, the teen was no longer overweight but still needed to take insulin.

One of the study's subjects, Amanda Munson, had Type 2 diabetes when she came to the Surgical Weight Loss Program for Teens. Now, 20 months after minimally invasive gastric bypass surgery, Munson is a diabetes-free sophomore in college. While her blood sugar still fluctuates from time to time, she says it is easily controlled with a snack and rest.

Prior to surgery, Munson used a pen-type device to administer insulin-like medication every time she ate, as well as any time her blood sugar was elevated between meals.

Although she has had to do some self-policing with certain foods that are not approved for her post-surgery diet, Munson says losing one-third of her weight and remaining diabetes free is well worth it.

Munson was also the first participant in the larger Teen-LABS research study, a project based at Cincinnati Children's and funded in 2006 by the National Institutes of Health. Teen-LABS will collect and report on the outcome of 200 teens undergoing weight loss surgery nationwide.

"In addition to the impressive weight loss and Type 2 diabetes results, patients undergoing the gastric bypass surgery also showed significant improvement in blood pressure, insulin, glucose, cholesterol and triglyceride levels." Inge said. "This is significant for the health of these teens, as it gives them an optimistic outlook for their future cardiovascular health."