[Type 2 diabetes and metabolic syndrome before and after gastric bypass]

Overweight and obesity are associated with an increased risk of acquiring type 2 diabetes and metabolic syndrome. We have assessed the prevalence of these conditions before and after gastric bypass surgery for morbid obesity.

The patients included had undergone laparoscopic gastric bypass at Oslo University Hospital Aker in the period 01.01.2007 - 31.12.2007 and had follow-up data for more than six months. Type 2 diabetes was defined as one or more of the following: an established diagnosis of diabetes before surgery, fasting plasma glucose >or= 7.0 mmol/l or HbA1c >or= 6.5 %. The metabolic syndrome was defined according to criteria laid out by the National Cholesterol Education Program.

136 patients (79 % women) with a mean (+/- SD) age of 43 +/- 9 years were included. Mean follow-up time was 17 months (range 8 - 26). The patients' body mass index (kg/m2) was reduced from 47 +/- 6 before to 32 +/- 6 after surgery (p<0.001). 34 % of patients had type 2 diabetes before and 10 % after surgery (p < 0.001). 80 % of patients had metabolic syndrome before and 24 % after surgery (p < 0.001). Fasting plasma glucose, HbA1c, and all variables included in the definition of metabolic syndrome were statistically significantly improved after surgery.

Gastric bypass has favourable effects on type 2 diabetes. Blood glucose normalised in most patients after the operation. The prevalence of metabolic syndrome was significantly lower after surgery.