Wednesday, February 26, 2014

Predicting the Effectiveness of Bariatric Surgery

Bariatric surgery is among the most effective weight loss methods. In addition to being an effective weight loss tool, bariatric surgery has also been shown to resolve type 2 diabetes in some cases. And now, a biomarker may help determine when bariatric surgery is likely to be an effective type 2 diabetes treatment.

Studies show that bariatric surgery, especially gastric bypass surgery, can resolve type 2 diabetes and other harmful metabolic conditions. But exactly which type 2 diabetics the surgery will probably help is generally not known. However, scientists at Helmholtz Zentrum München and the University of Cincinnati in Ohio report that GLP-1, a hormone "secreted by the gastrointestinal tract, can predict the metabolic efficacy of a gastric bypass," at least in rats.

GLP-1 normally increases in the blood after gastric bypass surgery. And looking at the animal study results, the researchers found that "the more responsive the animals were to GLP-1, the greater the efficacy of the gastric bypass turned out to be regarding glucose metabolism improvements." These results may help providers and patients decide on the appropriateness of bariatric surgery rather than less aggressive treatments.

Indeed, more understanding of when bariatric surgery is or is not appropriate, in general, is important for reasons other than treating type 2 diabetes. While some experts believe that bariatric surgery reduces healthcare costs, some researchers conclude that bariatric surgery does not necessarily reduce  long term healthcare costs, because "hospital stays for complications from the procedure exceed savings from obesity-related illnesses..." Furthermore, the surgery is not always effective for long term weight loss.

So, developing a biomarker to determine the appropriateness of bariatric surgery for type 2 diabetes may lead to methods that can help healthcare providers decide when the surgery is appropriate for weight loss, and when it is not. Bariatric surgery may not provide the results desired, and the surgery may not always be cost effective.

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