The April 27, 2011 issue of Science Translational Medicine included a study titled “Differential Metabolic Impact of Gastric Bypass Surgery Versus Dietary Intervention in Obese Diabetic Subjects Despite Identical Weight Loss.”
Melissa Bagloo, MD, Assistant Professor of Clinical Surgery at the Center for Metabolic and Weight Loss Surgery, NYP/Columbia, explains the context and importance of this study.
Q: What did this study find?
Dr. Bagloo: For years, surgeons have observed that gastric bypass surgery cures diabetes in over 80% of patients with diabetes. This improvement in blood sugar levels happens almost immediately after surgery, and far before any significant weight loss occurs. What’s more, studies have found that when patients lose the same amount of weight through diet as other patients lose after surgery, those who had surgery experience significantly better improvement in their diabetes than those who lost weight non-surgically. So we know surgery dramatically improves or resolves diabetes, but we do not know why this happens.
This recent study in Science Translational Medicine found an important clue as to why this effect may occur. The researchers found that after gastric bypass surgery, the levels of a certain type of amino acids (branched-chain amino acids) circulating in the blood were significantly reduced. This reduction in amino acids improved patients’ sensitivity to insulin, having the effect of normalizing their blood sugar levels.
Q: Why is this finding important?
Dr. Bagloo: The molecular mechanisms that cause diabetes are still unknown to us. Elevated amino acids have been identified previously in diabetic patients, but this is the first study to compare surgical with non-surgical weight loss. In that context, observing reduced amino acids after surgery clearly adds to our body of knowledge about the role they may play in the mechanisms underlying diabetes.
Q: Do you perform weight loss surgery specifically to treat diabetes?
Dr. Bagloo: The use of weight loss surgery to treat diabetes is called metabolic surgery, and as our knowledge has increased, metabolic surgery has become a very important therapeutic option for patients with morbid obesity and diabetes. The Center for Metabolic and Weight Loss Surgery at NYP/Columbia has been at the forefront of advancing and studying metabolic surgery for about a decade, and the use of metabolic surgery has been well established in diabetic patients with a body mass index (BMI) of 35 or greater. At this time, we are now studying the effect of weight loss surgery among patients with diabetes and BMI between 30-35. Select patients with BMI between 30-35 may be eligible for participation in the Diabetes Surgery Study, which is currently underway.
Visit the NYP/Columbia Center for Metabolic and Weight Loss Surgery or call 212.305.4000 for more information about metabolic surgery or the Diabetes Surgery Study. Read more about the Science Translational Medicine study in NPR’s health blog post, “New Clues To Why Gastric Bypass Surgery Cures Type 2 Diabetes”.
*This blog post was originally published at Columbia University Department of Surgery Blog*