Researchers at Capital Medical University in Beijing, China, looked at one hundred and one people diagnosed with Type 2 diabetes and who had decided to undergo gastric bypass – Roux-en-Y. The aim was to discover which people with diabetes would benefit most from the procedure. Their results were reported on in the journal Obesity Surgery in February of 2019.

Roux-en-Y gastric bypass involves making a stomach pouch from a small portion of the stomach. It is then attached to the small intestine, therefore bypassing a large section of the stomach and duodenum.

After the gastric or stomach bypass was performed, 71 or 70.3 percent, achieved remission, having…

• HbA1c levels of less than 6.5 percent,
• fasting blood sugars of less than 100 mg/dL, and
• not needing oral antidiabetic medications for at least one year.

The following characteristics were seen in those who went into remission…

• HbA1c reading less than 7.5 percent,
• a history of having Type 2 diabetes for less than 9.5 years,
• a C-peptide reading greater than 1.2 ng/mL, and were
• not being treated with insulin.

HbA1c is a measure of the sugar in hemoglobin, the molecule that moves oxygen in the red blood cells. Each red blood cell carries about 500,000 hemoglobin molecules. Red blood cells last about 120 days, so measuring the HbA1c gives us a report card of blood sugar levels over the previous 3 to 4 months…

• normal HbA1c levels range from 4 to 5.6 percent.
• in prediabetes, the gray area in which people are prone to develop full-blown Type 2 diabetes, HbA1c readings range from 5.7 to 6.4 percent.
• an HbA1c of 6.5 or higher indicates Type 2 diabetes.

C-peptide, a small chain of amino acids, is released when insulin is produced. Measuring it in the blood or urine gives the physician an idea of how well the beta cells in the pancreas are functioning. If the pancreas slows down and produces less insulin, then insulin can be added to oral medications. According to the study, if stomach bypass surgery is to be performed, it should be done during the first decade, and when the pancreas is still producing a good supply of insulin.

When stomach bypass surgery has been carried out, the recovering patient must follow a dietary plan to make the new digestive process work. The Mayo Clinic in the United States recommends…

• drinking eight 8 ounce glasses of water each day, between meals,
• eating and drinking slowly,
• eating lean, high-protein, low-sugar foods,
• avoiding alcohol,
• limiting caffeine,
• taking daily vitamin and mineral supplements, and
• chewing food thoroughly.