Obesity Surgery

, Volume 24, Issue 6, pp 835–840 | Cite as

Resolution of Diabetes After Bariatric Surgery Among Predominantly African-American Patients

Race has no Effect in Remission of Diabetes After Bariatric Surgery
  • Mereb Araia
  • Michael Wood
  • Joshua Kroll
  • Abdul Abou-Samra
  • Berhane SeyoumEmail author
Original Contributions



The aim of this study was to assess the relative efficacy in diabetes remission among predominantly African-American patients who have undergone one of the three different types of bariatric surgical procedures.


A total of 597 morbidly obese patients underwent one of the three bariatric surgical procedures at Harper University Hospital, Detroit, Michigan from 2008 to 2011. Of the three procedures, 203 (34 %) patients had laparoscopic sleeve gastrectomy, 264 (44.2 %) patients had laparoscopic gastric bypass, and 130 (21.8 %) had laparoscopic adjustable gastric banding. The prevalence of diabetes prior to surgery was 20.7, 17.4, and 24 %, respectively. There was no statistical difference in the prevalence of diabetes among the three surgical groups.


Of the 119 patients with diabetes, 46 (38.7 %) were males and 73 (61.3 %) were females. The majority of patients were African-Americans (65 %). The average age of patients was 42.2 ± 8.3 years for sleeve gastrectomy, 44.8 ± 7.9 years for gastric banding, and 41.5 ± 7.7 years for gastric bypass surgery. Of all the study patients with a preoperative diagnosis of type 2 diabetes, 86 patients (72.3 %) had resolution of diabetes 1 year after surgery. The resolution of diabetes was reported in 89.1, 66.7, and 54.8 % of patients who underwent laparoscopic gastric bypass, sleeve gastrectomy, and gastric banding, respectively.


This study, which was conducted among predominantly African-Americans, showed consistent results with other studies. Patients who underwent laparoscopic gastric bypass appeared to benefit the most in terms of achieving better remission of diabetes.


Diabetes African-Americans Bariatric surgery 


Conflict of Interest

All authors have no conflict of interest, and there was no external funding for the study.


  1. 1.
    Arroyo K, Kini SU, Harvey JE, et al. Surgical therapy for diabesity. Mt Sinai J Med. 2010;77(5):418–30.PubMedCrossRefGoogle Scholar
  2. 2.
    Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA. 2003;289(1):76–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Mokdad AH, Ford ES, Bowman BA, et al. Diabetes trends in the U.S.: 1990-1998. Diabetes Care. 2000;23(9):1278–83.PubMedCrossRefGoogle Scholar
  4. 4.
    Buse JB, Caprio S, Cefalu WT, et al. How do we define cure of diabetes? Diabetes Care. 2009;32(11):2133–5.PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Gumbs AA, Modlin IM, Ballantyne GH. Changes in insulin resistance following bariatric surgery: role of caloric restriction and weight loss. Obes Surg. 2005;15(4):462–73.PubMedCrossRefGoogle Scholar
  6. 6.
    Lee WJ, Huang MT, Wang W, et al. Effects of obesity surgery on the metabolic syndrome. Arch Surg. 2004;139(10):1088–92.PubMedCrossRefGoogle Scholar
  7. 7.
    Pournaras DJ, Aasheim ET, Sovik TT, et al. Effect of the definition of type II diabetes remission in the evaluation of bariatric surgery for metabolic disorders. Br J Surg. 2012;99(1):100–3.PubMedCrossRefGoogle Scholar
  8. 8.
    Milone M, Di Minno MN, Leongito M, et al. Bariatric surgery and diabetes remission: sleeve gastrectomy or mini-gastric bypass? World J Gastroenterol. 2013;19(39):6590–7.PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Albeladi B, Bourbao-Tournois C, Huten N. Short- and midterm results between laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy for the treatment of morbid obesity. J Obes. 2013;2013:934653.PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Yip S, Plank LD, Murphy R. Gastric bypass and sleeve gastrectomy for type 2 diabetes: a systematic review and meta-analysis of outcomes. Obes Surg. 2013;23(12):1994–2003.PubMedCrossRefGoogle Scholar
  11. 11.
    Mingrone G. Role of the incretin system in the remission of type 2 diabetes following bariatric surgery. Nutr Metab Cardiovasc Dis. 2008;18(8):574–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Franco JV, Ruiz PA, Palermo M, et al. A review of studies comparing three laparoscopic procedures in bariatric surgery: sleeve gastrectomy, Roux-en-Y gastric bypass and adjustable gastric banding. Obes Surg. 2011;21(9):1458–68.PubMedCrossRefGoogle Scholar
  13. 13.
    Mingrone G, Castagneto-Gissey L. Mechanisms of early improvement/resolution of type 2 diabetes after bariatric surgery. Diabetes Metab. 2009;35(6 Pt 2):518–23.PubMedCrossRefGoogle Scholar
  14. 14.
    Campos GM, Rabl C, Roll GR, et al. Better weight loss, resolution of diabetes, and quality of life for laparoscopic gastric bypass vs banding: results of a 2-cohort pair-matched study. Arch Surg. 2011;146(2):149–55.PubMedCrossRefGoogle Scholar
  15. 15.
    Suter M, Giusti V, Heraief E, et al. Laparoscopic Roux-en-Y gastric bypass: initial 2-year experience. Surg Endosc. 2003;17(4):603–9.PubMedCrossRefGoogle Scholar
  16. 16.
    Ponce J, Haynes B, Paynter S, et al. Effect of lap-band-induced weight loss on type 2 diabetes mellitus and hypertension. Obes Surg. 2004;14(10):1335–42.PubMedCrossRefGoogle Scholar
  17. 17.
    Dixon JB, O'Brien PE, Playfair J, et al. Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial. JAMA. 2008;299(3):316–23.PubMedCrossRefGoogle Scholar
  18. 18.
    Schauer PR, Burguera B, Ikramuddin S, et al. Effect of laparoscopic Roux-en Y gastric bypass on type 2 diabetes mellitus. Ann Surg. 2003;238(4):467–84. discussion 484-465.PubMedCentralPubMedGoogle Scholar
  19. 19.
    Buchwald H, Estok R, Fahrbach K, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122(3):248–56. e245.PubMedCrossRefGoogle Scholar
  20. 20.
    Pories WJ, Swanson MS, MacDonald KG, et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg. 1995;222(3):339–50. discussion 350-332.PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Gloy VL, Briel M, Bhatt DL, et al. Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ. 2013;347:f5934.PubMedCentralPubMedCrossRefGoogle Scholar
  22. 22.
    DeMaria EJ, Sugerman HJ, Kellum JM, et al. Results of 281 consecutive total laparoscopic Roux-en-Y gastric bypasses to treat morbid obesity. Ann Surg. 2002;235(5):640–5. discussion 645-647.PubMedCentralPubMedCrossRefGoogle Scholar
  23. 23.
    Schauer PR, Ikramuddin S, Gourash W, et al. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg. 2000;232(4):515–29.PubMedCentralPubMedCrossRefGoogle Scholar
  24. 24.
    Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.PubMedCrossRefGoogle Scholar
  25. 25.
    Bradley D, Conte C, Mittendorfer B, et al. Gastric bypass and banding equally improve insulin sensitivity and beta cell function. J Clin Invest. 2012;122(12):4667–74.PubMedCentralPubMedCrossRefGoogle Scholar
  26. 26.
    de la Cruz-Munoz N, Messiah SE, Arheart KL, et al. Bariatric surgery significantly decreases the prevalence of type 2 diabetes mellitus and pre-diabetes among morbidly obese multiethnic adults: long-term results. J Am Coll Surg. 2011;212(4):505–11. discussion 512-503.PubMedCrossRefGoogle Scholar
  27. 27.
    Smith Jr SC. Multiple risk factors for cardiovascular disease and diabetes mellitus. Am J Med. 2007;120(3 Suppl 1):S3–11.PubMedCrossRefGoogle Scholar
  28. 28.
    Gu YC, Yu JC. Mechanisms of gastrointestinal surgery in treatment of type 2 diabetes. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2011;33(3):262–4.PubMedGoogle Scholar
  29. 29.
    Rizzello M, Abbatini F, Casella G, et al. Early postoperative insulin-resistance changes after sleeve gastrectomy. Obes Surg. 2010;20(1):50–5.PubMedCrossRefGoogle Scholar
  30. 30.
    Myers VH, McVay MA, Adams CE, et al. Actual medical and pharmacy costs for bariatric surgery: 6-year follow-up. South Med J. 2012;105(10):530–7.PubMedCrossRefGoogle Scholar
  31. 31.
    Herman WH. The economic costs of diabetes: is it time for a new treatment paradigm? Diabetes Care. 2013;36(4):775–6.PubMedCentralPubMedCrossRefGoogle Scholar
  32. 32.
    Terranova L, Busetto L, Vestri A, et al. Bariatric surgery: cost-effectiveness and budget impact. Obes Surg. 2012;22(4):646–53.PubMedCrossRefGoogle Scholar
  33. 33.
    Hoerger TJ, Zhang P, Segel JE, et al. Cost-effectiveness of bariatric surgery for severely obese adults with diabetes. Diabetes Care. 2010;33(9):1933–9.PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Mereb Araia
    • 1
  • Michael Wood
    • 1
  • Joshua Kroll
    • 1
  • Abdul Abou-Samra
    • 2
  • Berhane Seyoum
    • 3
    Email author
  1. 1.Harper Bariatric Medicine Institute, Harper University HospitalWayne State University School of MedicineDetroitUSA
  2. 2.Hamad Medical CorporationDohaQatar
  3. 3.Division of EndocrinologyWayne State University School of MedicineDetroitUSA

Personalised recommendations