diabetes remission with weight loss surgeryWeight-loss surgery, like a gastric sleeve or gastric bypass, is designed for individuals with obesity. Numerous studies have proven that weight loss surgery relieves or improves diabetes diagnosis. Restrictive and malabsorptive gastric procedures reverse Diabetes Type 2 Mellitus (T2DM) even before the patient loses weight.

Research studies shows that 87% of patients with T2DM attain better glucose control and an 78% of them reach normal glycemic control.[1] Cleveland Clinic of Bariatric and Metabolic Institute* study sees nearly 24% of all patients achieved long-term complete remission with HbA1c of less than 6% .

More and more people are now opting for Weight Loss Surgery in Mexico to cure their type II diabetes. To understand how weight loss surgery is beneficial for curing diabetes, we should know the probable link between obesity and diabetes.

The Link Between Diabetes And Obesity

Insulin Helps Cells Absorb Sugar (Glucose)Obesity and Diabetes (Diabesity) are closely related since it has been found that most diabetic people (86%) are obese. Studies also indicate that an obese person has twice the risk of having Type 2 diabetes in comparison with other people who are of average weight.

Excessive fat on the abdomen is an indicator of the overexerted condition of the insulin-producing cells, or the beta cells, of the pancreas. These beta cells of the pancreas get under extra stress due to excess belly fat, which makes them work harder to produce more insulin to meet the overwhelming demand of the body, and this, in turn, exhausts the pancreas.

The exhausted pancreas causes the lack of insulin in the body, which increases blood sugar levels and causes Type 2 diabetes. The insulin the pancreas produces is required for the body to produce energy from blood sugar or glucose. Thus, it is crucial to maintain the levels of insulin in the body. Reducing the excess fat in the body diminishes the body’s requirement for insulin, and the pancreas recuperates.

One should be aware that a diabetic condition can lead to kidney damage, heart disease, and even blindness. Therefore, more and more people should be conscious of the connection between obesity and diabetes. With this knowledge, one can fight obesity and reduce the incidence of this deadly disease.

Statistics: Obesity Statistics for 2013 in the US, Canada, and the World

How Bariatric Surgery Helps Diabetes

insulin resistance injection into the fatty abdominal tissue - Mexico Bariatric CenterBariatric and metabolic surgeries like Vertical Sleeve Gastrectomy (VSG)RNY Gastric Bypass, or Duodenal Switch are powerful weapons against diabetes. Three major mechanisms contribute to the control of diabetes type 2 in bariatric patients dealing with weight problems (according to NIH). Basically, sustained glycemic levels are achieved by:

  1. Imposed caloric intake
  2. Enhanced insulin sensitivity
  3. Increased insulin secretion

There are three ways to explain the regression of type 2 diabetes after a weight-loss operation:

  • Hypothesis 1: A reduction in the body’s insulin resistance and increased insulin sensitivity have been observed in both gastric sleeve and gastric bypass patients due to restricted caloric intake.
  • Hypothesis 2: There is less lipotoxicity (accumulation of lipids) due to a reduction in insulin resistance after gastric bypass surgery.
  • Hypothesis 3: Changes in the Gut hormones alter the body’s response to carbohydrate and fat absorption after a weight-loss operation, such as gastric bypass.

Bariatric surgery can help you avoid diabetes if the surgery is done before developing diabetes. Also, it can help reduce the symptoms of Type 2 diabetes if you are already afflicted with it. So, if you are frustrated with your obesity as well as your diabetic condition, you may consult Mexico Bariatric Center expert surgeons regarding Bariatric surgery.

Related: Bariatric Surgery Improves Adipose Tissue Function

Additional Benefits

Diabetes Risk Factors and Complications

Many of the diabetes (diabetic + obese) subjects had an increased risk of Chronic Kidney Disease (CKD) or were experiencing the early stages of CKD. Many times, CKD is due to high blood pressure and/or diabetes. The studies report that almost every patient who had experienced this diagnosis was not at risk after bariatric surgery occurred.

According to the American Medical Association, nearly 36% of Americans have an increased risk of heart attack, stroke, certain cancers, or Type 2 Diabetes due to their disease of Obesity. While many argue that bariatric surgery is dangerous, less than 1% of all procedures experience any complications at all with Mexico Bariatric Center®.

In terms of treating uncontrolled diabetes, it’s imminent that weight loss surgery is a healthy way for one to not only control their obesity and change their lifestyle but also treat their Type 2 Diabetes.

Weight Loss Surgery For Diabetes

1. Gastric Bypass Surgery seems to be a promising solution for curing Type 2 diabetes. In this procedure, the stomach is reduced surgically, which limits the amount of food they consume and makes the individual eat less. The length of the intestine is also shortened, which prevents the body from absorbing too many calories and getting rid of excess glucose. This helps in normalizing the levels of sugar in the blood.

According to the American Diabetes Association (ADA), 78% of individuals with Type 2 diabetes showed relief from diabetes symptoms after receiving gastric bypass surgery. Due to these encouraging results, ADA suggests gastric bypass surgery as one successful treatment for overweight and diabetic individuals.

2. Gastric Sleeve Surgery outcomes show a reversal of diabetes type II, similar to gastric bypass. The narrow tube-like stomach left after the procedure creates restrictions to limit food intake. Gastric sleeve changes glucose metabolism as well as gut hormones that favor improvement in diabetes.

3. Biliopancreatic Diversion is one of the most bariatric procedures to resolve type 2 diabetes. Studies have shown that bypass of the duodenum (i.e., BPD) improves insulin resistance immediately postoperatively, much more rapidly than sleeve gastrectomy.

Studies on Type 2 Diabetes and Bariatric Surgery

Ultimately, bariatric surgery results in a remission rate of up to 90% of individuals in the first two years after surgery. However, many studies have assessed various outcomes, and nothing has been found about why some people have long-lasting remission and others do not.

– Cleveland Clinic Studies

Cleveland Clinic Studies: According to a study by the Cleveland Clinic of Bariatric and Metabolic Institute*, nearly 24% of all patients and 31% of their gastric bypass patients have achieved total remission. The Cleveland Clinic study shows that with continued weight loss, sugar loss remained healthy, and patients tossed the medication they took before weight loss began.

About the Study

  • # of Subjects Studied: 10 patients, leading to an average body mass index reduction of nearly 27% and A1c’s that dropped from 10% to just 8.9%.
  • Bariatric Surgery Procedures: The patients had adjustable gastric banding (2 patients), gastric sleeve surgery (1 patient), or laparoscopic Roux-en-Y gastric bypass surgery (7 of 10 patients).
  • Duration: At their follow-up visits almost 37 months after their initial procedure, 9 of the 10 patients lost more than 60% of their weight, and their average daily insulin intake went from .74 to .40 U/kg (reduced by almost half).

Statistics and Results

According to the study, nearly 34% of the subject population demonstrated an improvement in their glycemic levels. Glycemic control wasn’t the only thing this study found; it lowered and healthier blood pressure and cholesterol levels as well.

  • Nine of the ten patients lost more than 60% of their weight, and their average daily insulin intake reduced from .74 to .40 U/kg (almost half).
  • Glycemic levels led to many patients being off their diabetes medication for more than five years.
  • 25% reduction in the number of cardiovascular traumas predicted in the patients studied.
  • Another study by the Cleveland Clinic proves the same facts. Nearly 80% of their bariatric surgery patients met target blood sugar levels of 7 percent HbA1c. The American Diabetes Association recommends this level.
  • 30% of the patients in the study experienced remission of their Type 2 Diabetes and were off their medication for at least five years.

These findings were published in Diabetes Care. The doctors of this study mention that their patient sample is too small to draw a large conclusion. They hope that it will encourage others to look at these same types of patients in more extensive studies to learn more about how bariatric surgery can be used as a therapy method for treating Type 1 Diabetes in morbidly obese patients.

– Swedish/Finland Clinic Studies

A Swedish study shows that bariatric surgery significantly improves Type 2 Diabetes in patients. The study reports that 72% of patients achieved remission in just two years after surgery compared to 16% who didn’t have surgery. Also, 15 years after surgery, 31% of those patients stayed in remission compared to 7% of control patients. This information was presented at the International Diabetes Federation.

About the Study

Newly-diagnosed patients maintained remission rates during their 2, 10, and 15-year follow-up visits (94%, 60%, and 47%) than those with diabetes for more than three years before surgery (39%, 12%, and 9%). The goal is to have bariatric surgery three years after diagnosis for the greatest chance of remission regarding excessive weight loss.

  • # of Cases Studied: This study evaluated 2,010 obese patients who had weight-loss surgery from 1987-2001 and were 37-60 years old.
  • # of Cases with Diabetes: 345 patients and 262 controls had type 2 diabetes.
  • Bariatric Surgery Procedures: 68.1% of the patients had vertical banded gastroplasty, 18.7% gastric banding, and 13.2% gastric bypass surgery.
  • Duration: The duration of diabetes diagnoses was 3 and 3.5 years in both the surgery and control groups, and fasting glucose levels were about 156 mg/dL for both.

Statistics

Nearly two years post-surgery, more than 90% of those who had diabetes for less than a year before surgery were in remission. Ultimately, remission rates at two years for those with diabetes for over three years were low.

  • Ultimately, for those with a disease for less than a year, there was a 53% reduction in complications from their diabetes and a .74 hazard ratio.
  • They concluded that there was a 47% reduction in stroke and myocardial infarction.
  • In the last 20 years, there was a 47% reduction in microvascular complications.
  • Nearly 34% fewer macrovascular complications.

– American Society for Metabolic and Bariatric Surgery

According to the American Society for Metabolic and Bariatric Surgery, more than 30 studies confirm the remission of diabetes after undergoing weight loss surgery. Similarly, a study in the New England Journal of Medicine in August 2007 indicates that diabetic people who chose weight loss surgery to cure their diabetes are highly benefited compared to others who tried other methods to ameliorate their diabetes.

– Journal of American Medical Association (JAMA)

The Journal of the American Medical Association (JAMA) found that those individuals who received a standard non-surgical therapy only lost approximately 1.7% of the body fat, but the people who underwent weight loss surgery lost up to 21% of the extra body fat and experienced relief from the symptoms of the diabetic condition.

  1. Dr. Neil E. Hutcher, MD, FACS, the past president of the American Society for Metabolic and Bariatric Surgery (ASMBS), and a Bariatric surgeon at Commonwealth Surgeons, thinks that weight loss surgeries are also beneficial for diabetic patients who are not obese or overweight. According to Dr. Hutcher, traditional treatments for diabetes are not enough to combat this disease. Individuals who receive medical therapies are at risk of losing limbs, having negative reactions to drugs, and going on dialysis.
  2. Dr. Jon Gould, head of the weight loss surgery program at the University of Wisconsin, said, “Surgery ought to be considered front-line therapy for diabetes among obese people.”

These treatment researchers have indicated that weight loss surgery helps lose weight and maintain blood sugar levels, thus reducing or eliminating the requirement for diabetes medicines.

More Information

Reference

  • www.healio.com September 20, 2013, Brethauer SA. Ann Surg.