Date of Graduation

Winter 12-19-2010

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Torry Cobb

Second Advisor

Anya Hill

Abstract

Background: Over 240 million people worldwide are affected by type II diabetes, and this number is expected to rise to over 380 million by the year 2025. As type II diabetes becomes exponentially more prevalent in our society, novel treatment options should be explored. Currently, the management of type II diabetes focuses on the prevention of disease progression through lifestyle modifications and medical therapy. Although there have been advances in the pharmacological treatment of type II diabetes, it still remains a poorly controlled disease. Emerging data suggest that bariatric surgery may provide a more sustained and effective treatment for type II diabetes.

Method: An extensive search of the literature using MEDLINE, PUBMED, UPTODATE and CINAHL were performed to identify the effects of gastric bypass surgery on type II diabetes for the purpose of performing a systematic review and assessing the outcomes using the GRADE system. Two randomized control trials, and one cohort study were identified.

Results: Based on the two randomized control trials and one cohort study, showed that the efficacy of gastric bypass surgery was significantly greater than diet and medication without surgery, in the treatment of type II diabetes in terms of reducing HbA1C and fasting plasma glucose.

Conclusion: Overall, the use of gastric bypass surgery in the treatment of type II diabetes significantly reduces HbA1c, fasting plasma glucose and the use of pharmacotherapy. This review of the outcomes using the GRADE system confirms the effectiveness of bariatric surgery as a therapy for type II diabetes.

Keywords: type 2 diabetes, gastric bypass

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