Gastric Bypass Surgery Can Affect Metformin Treatment
What is the problem and what is known about it so far?
Extreme obesity is on the rise and is linked to early death and higher risk of serious diseases, including diabetes. Because diet and exercise often fail to control extreme obesity, surgical options have become common. Gastric bypass surgery is a procedure in which the stomach is made smaller and food bypasses a part of the small intestine. This helps patients to lose a large amount of weight. Gastric bypass surgery in extremely overweight diabetic patients often leads to remission of their diabetes. However, over 40 percent may develop diabetes again within five years. Also, 25 percent of diabetic gastric bypass patients still require diabetes medication. Metformin is a drug commonly used to treat type 2 diabetes. It is therefore important to understand how gastric bypass surgery affects the way the body uses metformin.
Why did the researchers do this particular study?
The researchers wanted to know if metformin is absorbed by the body more or less after gastric bypass surgery. They also wanted to know how this affects blood glucose levels.
Who was studied?
The study included 32 nondiabetic patients from a regional obesity clinic. Sixteen of them had gastric bypass surgery at least 3 months before the study.
How was the study done?
The participants were given metformin, and then blood and urine samples were taken several times over 24 hours. The measure of blood showed the drug’s impact on glucose levels, and the measure of urine showed how much of the drug had been absorbed.
What did the researchers find?
The gastric bypass patients seemed to absorb greater amounts of metformin and their glucose levels were lower compared with the other participants.
What were the limitations of the study?
Participants were given a single dose of metformin on an empty stomach. While this method can provide insight quickly, it does not show the full effect of the drug under usual conditions, where patients have had food and have taken the medication regularly.
What are the implications of the study?
Gastric bypass surgery seems to increase the body’s ability to absorb metformin. This means that patients taking metformin—and similar drugs—may need a change in their dosage if they have gastric bypass surgery.
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