hormonal change after gastric bypass for diabetics

By mkhojh99 Latest Reply 2011-02-24 17:28:38 -0600
Started 2011-02-20 11:22:53 -0600

ok found some info on this a little…but heres what I was asking if anyones heard of this change…that has to do with gastric bypass.

Hormonal changes after Roux-en Y gastric bypass for morbid obesity and the control of type-II diabetes mellitus.
Clements RH, Gonzalez QH, Long CI, Wittert G, Laws HL.

Department of Surgery, Section of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Morbid obesity (MO) is associated with diabetes mellitus-type II (DM-II). Roux-en Y gastric bypass (RNY) has been shown to normalize glucose intolerance in these patients through an incompletely understood mechanism. Gastrointestinal hormonal changes have been suggested as an explanation for resolution of DM II.
Fasting plasma glucose decreased significantly within 2 weeks after RNY. Insulin and cortisol both approached, but never achieved, significant changes over 12 weeks. GLP-1 increased initially, but not significantly. GIP and C-peptide both decreased significantly. Glucagon remained essentially unchanged over 12 weeks. RNY rapidly normalizes fasting plasma glucose in morbidly obese patients with DM-II. GIP, a gactor in the enteroinsulin axis, decreases and may play a role in the correction of DM-II after gastric bypass.

BACKGROUND: The surgical treatment of diabetes had witnessed progressive development and success since the first case of pancreatic transplantation. Although this was a great step, wide clinical application was limited by several factors. Bariatric surgery such as gastric bypass is emerging as a promising option in obese patients with type 2 diabetes. The aim of this article is to explore the current application of gastric bypass in patients with type 2 diabetes and the theoretical bases of gastric bypass as a treatment option for type 1 diabetes.

METHODS: We performed a MEDLINE search for articles published from August 1955 to December 2008 using the words "surgical treatment of diabetes," "etiology of diabetes" and "gastric bypass."

RESULTS: We identified 3215 studies and selected 72 relevant papers for review. Surgical treatment of diabetes is evolving from complex pancreatic and islets transplantation surgery for type 1 diabetes with critical postoperative outcome and follow-up to a metabolic surgery, including gastric bypass. Gastric bypass (no immune suppression or graft rejection) has proven to be highly effective treatment for obese patients and nonobese animals with type 2 diabetes. There are certain shared criteria between types 1 and 2 diabetes, making a selected spectrum of the disease a potential target for metabolic surgery to improve or cure diabetes.

CONCLUSION: Roux-en-Y gastric bypass is a promising option for lifelong treatment of type 2 diabetes. It has the potential to improve or cure a selected spectrum of type 1 diabetes when performed early in the disease. Further animal model studies or randomized controlled trials are needed to support our conclusion
Im not sure I really understand all this but this is where I got the info


Has anyone whos had the surgery had this effect???? I know its a lifestyle change and you have to completely be committed and all but…this change is what I wanna know more about

7 replies

mkhojh99 2011-02-24 17:28:38 -0600 Report

thanks for the replys…I am stil considering this…some days I wanna be healthier because at 230 weight it affects how I feel

nana2005 2011-02-24 05:43:58 -0600 Report

well Dear I wish you all the best as long as you feel that you are doing the right thing . good luck, and God Bless you

Nanny G
Nanny G 2011-02-23 22:13:33 -0600 Report

My Endo has been telling me that this is the way to go. My cardiologist confirmed the same. Both said the patients with Type 2 that have done a RNY have put their diabetes into complete remission and no longer take any meds. Most usually go off BP and cholesterol meds too.

jayabee52 2011-02-23 22:26:57 -0600 Report

It MIGHT work for you Nanny G but it also might NOT. Or it may work for a while, and then the Diabetes may come back later. You can't unbreak an egg, & you can't undo a surgery like that.

It's up to you, of course. It's your body.

Blessings to you and yours


Nanny G
Nanny G 2011-02-23 22:54:31 -0600 Report

I have been doing research on this for almost 2 years while my Endo keeps pushing. My son is a PhD in clinical Pharmacology and has done research for me also and he fully supports this decision. This is part of an email he sent including a link for info on results/comparisons

Mom -
I found this very informative, helpful web page from the well-renowned Cleveland Clinic on Bariatric surgery. I'm sure you've heard most of this info already, but the evidence is certainly compelling. The 2 attachments go hand-in-hand with this. The diabetes stats from the ASMBS are directly from 2009 CDC report. The papers from AJM are stats from meta-analysis from over 135,000 pts. Important to take note of the different procedures performed and the > 2yr reported results (Table 7). I believe this to be a very good possibility after reviewing all the research and there has been A LOT done from many big facilities. But you know me and we are constantly working on new products but they are only in early clinical trials. Don’t know how long you want to keep putting this off.
I believe new therapeutics will greatly help like the incretins (we have 1 in clinic currently that is GLP-1 agonist fused with monoclonal antibody for longer half-life/bioavailability), but you can't deny the published results about the RNY. Lap band is OK but doesn’t show the same long term results. Always something to think about.


jayabee52 2011-02-23 23:12:15 -0600 Report

Well your son seems to have done his homework. The decision is up to you, of course, and you don't have to defend any decision you make to me or anyone else for that matter. It is YOU which have to live with the reults (positive or negative) 24/7/365. I pray you come to the best decision for YOU, whatever it may be.

Nanny G
Nanny G 2011-02-23 23:26:38 -0600 Report

I haven't made any decisions yet … just 8 weeks post op from gall bladder surgery and trying to get my strength back cuz my lungs collapsed 16 hrs after surgery. So i know NO surgery is without the possibility of complications.