Many people don’t know that type 2 diabetes can be reversed. Lifestyle changes like diet and exercise can go a long way toward managing the disease, but they're not always enough to stop it from progressing and causing other serious health complications. In that case, weight-loss surgery may be a solution for some people with type 2 diabetes.
Excess weight often plays a significant role in the development of type 2 diabetes, since both conditions are driven by problems with the body's metabolism. That means losing weight can often help send type 2 diabetes into remission — especially if the weight loss is significant.
Bariatric surgery can be an effective tool to make that happen. As a weight-loss surgeon, I've seen firsthand how bariatric procedures can help patients with type 2 diabetes lose a large amount of excess weight quickly, which can reduce or end their dependence on diabetes medications.
If you have type 2 diabetes and are considering weight-loss surgery or want to learn more about how it may be able to help you, join our free virtual bariatric seminar.
How exactly does bariatric surgery help type 2 diabetes?
Type 2 diabetes occurs when a person's body becomes resistant to insulin, the hormone that controls blood sugar levels. When the body becomes resistant to insulin, it can be harder to keep blood sugar levels from getting too high, which can lead to a higher risk for heart disease, stroke, kidney failure, and even blindness.
Weight-loss surgery treats type 2 diabetes in two important ways:
- Helps people achieve a healthier body mass index (BMI) by reducing their food intake and decreasing the number of calories their body can absorb. This alone can decrease a person's insulin resistance and make blood sugar easier to control.
- Triggers changes to gut hormones that encourage healthier metabolism and more stable blood sugar levels.
Weight-loss surgery has been shown to reduce the body's production of ghrelin, the hormone that stimulates appetite. At the same time, the surgery increases the production of hormones such as GLP-1, which has a positive effect on insulin production. With more insulin available, the body is better able to move blood sugar into the cells to be used for energy, rather than letting it build up in the bloodstream.
These changes can begin to take place soon after surgery, to the point where many of my patients have been able to lower their dosage of diabetes medication right away. Within 2 years, the majority of them experience remission of their diabetes and no longer need to take any medication at all. As you could imagine, they are thrilled with that result!
When my patients’ diabetes symptoms decrease, their health improves in other ways as well. Their risk for complications like heart attack, stroke, and kidney failure drops. Conditions like sleep apnea and fatty liver disease often get better, too.
Is bariatric surgery a permanent cure for type 2 diabetes?
Like I’ve mentioned before, weight-loss surgery has significant potential to send a patient's type 2 diabetes into remission. That doesn't mean that their diabetes is cured, but rather that it is controlled to the point where they no longer need to take medication to stabilize their blood sugar levels. However, their symptoms may come back and medication may be needed if a patient regains the lost weight.
In some cases, it may be possible for patients to achieve a complete resolution of their type 2 diabetes. I’ve had that happen with some of my patients. This is more likely for those who were diagnosed with diabetes less than 5 years ago and were not taking blood sugar medication prior to bariatric surgery.
What weight-loss surgery options are available?
Here at Temple Health, patients with type 2 diabetes receive two types of weight-loss surgery:
- Gastric bypass reduces your stomach size and reroutes the gastrointestinal tract so that food bypasses most of the stomach and part of the small intestine, reducing the number of calories the body can absorb.
- Gastric sleeve operations remove a portion of the stomach, making the stomach smaller and narrower. Gastric sleeve procedures can decrease the body's production of appetite-increasing hormones.
Both gastric bypass and gastric sleeve surgeries are highly effective and can lead to significant weight loss. There are benefits and risks to both surgeries, and one isn't universally better than the other. In my practice, patients and I discuss their needs and preferences to make a personalized recommendation on which surgery is best for them.
Who qualifies for weight-loss surgery?
One of the main factors I use to determine whether a patient is a good candidate for weight-loss surgery is BMI. Those who have a BMI of 35 or greater are typically a good fit.
We have good evidence to show that weight-loss surgery is also beneficial for patients with type 2 diabetes who have a BMI of 30 or greater, particularly if the patient's diabetes isn't well controlled.
If you’re curious about where your BMI stands in relation to these qualifications, use our BMI calculator tool.
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