May 23, 2019 | Updated: 11:35 AM EDT

Early Gastric Bypass Surgery May Improve Type 2 Diabetes, Blood Pressure Outcomes

May 16, 2019 08:32 PM EDT

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Early Gastric Bypass Surgery May Improve Type 2 Diabetes, Blood Pressure Outcomes
(Photo : Children's Hospital Colorado)

Regardless of related weight loss, teens that had gastric bypass surgery were significantly more likely to have remission of both type 2 diabetes and high blood pressure, compared to adults who had the same procedure. Outcomes are from NIH-funded research comparing results in the two groups five years after surgery. Earlier, no treatment has shown longer-term effectiveness at reversing type 2 diabetes in youth, which tends to advance more quickly than in adults.

The team of researchers evaluated 161 teens and 396 adults who underwent this surgery at clinical centers participating in Teen-LABS (Teen-Longitudinal Assessment of Bariatric Surgery) and its adult counterpart, LABS. In the study, teens under 19 years old were at the time of surgery, and adults in the survey reported having obesity by age 18. Teen-LABS clinical centers have specialized experience in the surgical evaluation and management of young people with severe obesity, and both studies were funded primarily by NIH's National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The team published the results of the research in the New England Journal of Medicine.

Critical findings of the research include:

  •  No difference in the overall weight loss percentage between the groups. Teens lost 26 percent of their body weight and adults lost 29 percent at five years after surgery
  •  There was a decline in Type 2 diabetes in both groups. However, teens with type 2 diabetes before surgery were 27 percent more likely than adults to have controlled blood glucose (blood sugar) without using diabetes medications
  •  No requirement of any teen in the group for diabetes medications after surgery compared to 88 percent of teens before surgery. 79 percent of adults used diabetes medications before surgery, and 26 percent used diabetes medications five years later
  •  Before surgery, 57 percent of teens and 68 percent of adults used blood pressure medications. Five years after surgery, 11 percent of teens and 33 percent of adults used blood pressure medications
  •  Among individuals with high blood pressure before surgery, teens were 51 percent more likely than adults to no longer have high blood pressure or take blood pressure medication

Teens were more likely, however, to have increased risks in other areas such as a need for subsequent abdominal surgeries, most commonly gall bladder removal. Teens were also more likely to have low iron and vitamin D levels, potentially because teens may be less likely to take enough vitamin and mineral supplements after surgery.

There was a similar death rate for both teens and adults five years after surgery, including two people from the teen group who died from an overdose. There is an overall increasing trend of drug overdose deaths in the U.S., and a previous LABS study found an increased risk of substance and alcohol use disorders after bariatric surgery in adults.

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