When you think of diabetes treatment, you probably think of weight loss, medication, and lifestyle changes like diet and exercise. You might not think of diabetes and bariatric surgery, but perhaps you should. Researchers have found that bariatric surgery, also known as weight loss surgery, may help patients with type 2 diabetes control their blood glucose levels better when traditional treatment options don't work. Some patients may no longer need their medication after bariatric surgery, and their diabetes may go into remission.
You're probably familiar with the term "gastric bypass," but this is just one of several bariatric surgery options.
The Roux-en-Y gastric bypass is the most well-known procedure. In this operation, the surgeon connects the top of the stomach to the small intestine, essentially bypassing the stomach. As a result of the smaller stomach cavity, you feel full faster and take in fewer calories. Another common procedure is the adjustable gastric band, where a surgeon places an inflatable band around the top of the stomach to create a smaller stomach pouch. Unlike a gastric bypass, this procedure is reversible.
Researchers aren't sure why bariatric surgery improves diabetes. Some believe that since patients take in fewer calories post-surgery, there is less blood glucose to manage and insulin sensitivity improves. Other researchers suggest that surgery may change the way the body and gut regulate hormones. Plus, the long-term effects of weight loss generally improve diabetes.
A recent study in the journal Diabetes Care found that 69 percent of obese patients with type 2 diabetes who underwent gastric bypass surgery and 30 percent of those who had gastric banding were in remission after three years. Other studies found that after three years, bariatric surgery resulted in lower blood sugar levels, more weight and fat loss, reduced need for diabetes medication, and lower cholesterol and blood pressure levels, in addition to partial or complete diabetes remission.
The American Diabetes Association recommends bariatric surgery for adults with type 2 diabetes and a body mass index (BMI) of 35 or above. More research is needed to determine if surgery is a good option for those with lower BMIs. Research suggests that early intervention is key; surgery may work best in patients soon after diagnosis.
As with all medical procedures, there are side effects and risks associated with bariatric surgery, such as internal hernia, bowel obstruction, and pulmonary embolism.
In addition, patients need to be physically and emotionally ready to make major changes following weight loss surgery, such as sticking to an exercise and diet plan. And since surgery isn't a cure, you do need to continue with regular monitoring to keep tabs on your diabetes.
The relationship between diabetes and bariatric surgery shows great promise for patients. Your doctor can help you decide if surgery is a treatment option worth considering.
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