Bariatric surgery shown to reverse diabetes related neuropathic complications among people with obesity

Bariatric surgery is increasingly been utilized to induce and maintain significant weight loss among patients with obesity. For patients with diabetes, bariatric surgery is associated with increased likelihood of reversal of type 2 diabetes; however, its impact on long-term diabetes related neuropathic complications remain unclear. This is particularly relevant given the potential increased risk of “treatment-induced neuropathy” associated with rapid improvements of glucose control. A study undertaken by research team from the University of Michigan have now reported that bariatric surgery may improve neuropathy by regenerating damaged nerves. In the study published in the journal Diabetologia, 120 patients who underwent bariatric surgery for obesity were followed up for over 2 years after the procedure. Metabolic risk factors such as high glucose, high blood pressure and lipid levels were significantly improved. The researchers also assessed two primary measures for peripheral neuropathy in patients with obesity by undertaking skin biopsies to assess nerve fibre density in the thigh and the leg. They observed that 2 years after bariatric surgery, nerve fibre density improved in the thigh and remained stable in the leg. This is particularly relevant given that the natural history of peripheral neuropathy among patients with obesity is often associated with a decline in nerve function, thus, stability in nerve fibre density is considered to be a good outcome. Furthermore, the observed improvement in nerve fibre density at the thigh indicate that bariatric surgery may be a successful therapy to improve or reverse peripheral neuropathy for patients with long-term metabolic impairment. This finding advances current therapeutic options for peripheral neuropathy, especially in patients with obesity which currently focuses on analgesia and neuropathic oral treatment such as gabapentin, amitriptyline, duloxetive, topical analgesics and non-medical treatments, like acupuncture and cognitive behavioural therapy.