Effect of Roux-en-Y gastric bypass on pharmacologic dependence in obese patients with type 2 diabetes

Abstract

Background: More than half the diabetes-related health care costs in Canada relate to drug costs. We aimed to determine the effect of Roux-en-Y gastric bypass (RYGB) on the use of insulin and orally administered hypoglycemic medications in patients with diabetes. We also looked to determine overall cost savings with the procedure. Methods: We reviewed the bariatric clinic records of all patients with a confirmed diagnosis of type 2 diabetes mellitus who underwent RYGB between 2010/11 and 2014/15. Percentage estimated weight loss was recorded at 1 year, along with reductions in glycated hemoglobin (HbA 1c) level and use of oral hypoglycemic therapy and insulin. We estimated medication costs using Manitoba-specific pricing data. Results: Fifty-two patients with at least 12 months of complete follow-up data were identified. The mean percentage estimated weight loss was 50.2%. The mean HbA 1c level decreased from 7.6% to 6.0%, the mean number of orally administered hypoglycemics declined from 1.6 to 0.2, and the number of patients receiving insulin decreased from 18 (35%) to 3 (6%) (all p < 0.001). The rate of resolution of type 2 diabetes was 71%.

Decolonising qualitative research to explore the experiences of Manitoba’s urban Indigenous population living with type 2 diabetes mellitus, obesity and bariatric surgery

“…Previous research suggests that bariatric surgery is an effective treatment for improvement of T2DM in obese patients. 9 Several studies, including multiple randomised control trials demonstrate that bariatric surgery is effective for weight loss and remission of T2DM and metabolic syndrome when compared with medical therapy alone in the overall population. 9–20 A study with Australian Indigenous populations demonstrated a 66% diabetes remission rate following gastric banding.…”

“… 9 Several studies, including multiple randomised control trials demonstrate that bariatric surgery is effective for weight loss and remission of T2DM and metabolic syndrome when compared with medical therapy alone in the overall population. 9–20 A study with Australian Indigenous populations demonstrated a 66% diabetes remission rate following gastric banding. 21 Although literature relating to Canada’s Indigenous bariatric surgery population is scarce, available research suggests that surgery is safe and effective, and this patient group may respond better to the intervention based on higher resolution rates of obesity-related comorbidities.…”