Weight-loss surgery (also called bariatric & metabolic surgery), like a gastric sleeve or gastric bypass, is usually designed for those individuals with obesity disease. Weight loss surgery has been proven in countless studies to relieve or improve Diabetes diagnosis. Most of these cases underwent Vertical Sleeve Gastrectomy, RNY Gastric Bypass, or Duodenal Switch surgeries. Gastric restrictive and bypass procedures reverse diabetes type 2 even before the patient starts to lose any weight.
Research studies shows that 87% of patients with T2DM attain better glucose control and an 78% of them reach normal glycemic control. 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 for curing their type II diabetes mellitus (T2DM).
Now, you must be wondering how weight loss surgery is beneficial for curing diabetes. To understand this in more detail, we should know the probable link between obesity and diabetes.
What Is The Link Between Diabetes And Obesity
Obesity and Diabetes (Diabesity) are closely related since it has been found that most diabetic people are usually 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 the blood sugar level and causes Type 2 diabetes. The insulin produced by the pancreas is required for the body to produce energy from blood sugar or glucose. Thus, it is crucial to maintaining the levels of insulin in the body. With the reduction of the excess fat of the body, the body’s requirement of insulin reduces and the pancreas recuperates.
One should be aware that diabetic condition can lead to kidney damage, heart diseases, and even blindness. Therefore, more and more people should be made conscious of the connecting link between obesity and diabetes. By having this knowledge, one can fight obesity and reduce the incidence of this deadly disease.
How Bariatric Surgery Helps Diabetes
There are three major mechanisms contributing to the control of diabetes type 2 in bariatric patients dealing with weight problems (according to NIH). Basically, sustained glycemic levels is achieved by:
- Imposed caloric intake
- Enhanced insulin sensitivity
- 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 an increase in 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 lipid) 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 the development of diabetes. Also, it can help reduces the symptoms of Type 2 diabetes if you are already afflicted with it. So, if you are frustrated with your obesity as well as diabetic condition, you may consult Mexico Bariatric Center expert surgeons regarding Bariatric surgery.
Many of diabetes (diabetic + obese) subjects had an increased risk of kidney disease or were experiencing the early stages (many times, this is due to high blood pressure 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, change their lifestyle but also treat their Type 2 Diabetes.
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 there has been nothing found about why some people have long-lasting remission and why others do not.
Cleveland Clinic Studies [Diabetes Study]
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 at healthy levels, and patients did not need medication they did 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 ten 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, but lower and healthier blood pressure and cholesterol levels as well.
- 9 of the ten 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).
- Glycemic levels leading to many patients studied 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 patients who had bariatric surgery met target blood sugar levels of 7 percent HbA1c. This level is recommended by the American Diabetes Association.
- 30% of the patients in the study experienced remission of their Type 2 Diabetes and were off of 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 the 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 [Diabetes Study]
A Swedish study shows that bariatric surgery shows significant improvement for Type 2 Diabetes 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 who had 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 in regards to 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: Included 345 patients and 262 controls that 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 both 3 and 3.5 years in both the surgery and control groups, and fasting glucose levels were about 156 mg/dL for both.
Nearly two years post-surgery, more than 90% of those who had diabetes for less than a year before surgery was in a remission state. Ultimately, remission rates at two years for those with diabetes for more than 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 [Diabetes Study]
According to the American Society for Metabolic and Bariatric Surgery, there are more than 30 studies confirming 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 in comparison to others who tried other methods to ameliorate their diabetes.
Journal of American Medical Association (JAMA)
The Journal of the American Medical Association or JAMA found out that those individuals who received a standard non-surgical therapy only lost approximately 1.7% of the body fat, but the people that undergone weight loss surgery lost up to 21% of the extra body fat, and experienced relief from the symptoms of the diabetic condition.
- 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 think that weight loss surgeries are also beneficial for diabetic patients that 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.
- Dr. Jon Gould, head of the weight loss surgery program at the University of Wisconsin, said that “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 also maintain blood sugar levels, thus reducing or eliminating the requirement of diabetes medicines.
Gastric Bypass Surgery For Diabetes
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 get 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.
Gastric Sleeve Surgery For Diabetes
Sleeve gastrectomy shows 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.
Biliopancreatic Diversion for Diabetes
Studies have shown that bypass of the duodenum (i.e. BPD) improves insulin resistance immediately postoperatively; much more rapidly than sleeve gastrectomy.
- 27 Recommended Diabetes Support Blogs and Resources as of 2018
- Cleveland Clinic Sees Significant Improvement of Obese Type I Diabetes After Weight Loss Surgery
- Reference: www.healio.com September 20, 2013, Brethauer SA. Ann Surg.