If you have type 2 diabetes, recent guidelines backed by the American Diabetes Association and 44 other respected health organizations say that weight-loss surgery could be a treatment option to consider, even if you are not considered morbidly obese. These recommendations highlight the profound effect of bariatric surgery on the treatment of diabetes associated with obesity.
Are you a candidate?
Past guidelines recommended bariatric surgery as a last resort for people who were morbidly obese, with a BMI (body mass index) of 40 or more, regardless of their overall blood sugar levels. An improvement in their diabetes conditions was a welcome side effect.
However, according to Dr. Zachary Ichter, a fellowship-trained surgeon with LG Health Physicians Healthy Weight Management & Bariatric Surgery, “More recent guidelines conclude that surgery should routinely be considered as an option for adults with inadequately controlled type 2 diabetes and a BMI of 35 or greater—the emphasis being on better blood sugar control, not weight loss.”
Diabetes is an increasingly common disease
Nearly 26 million Americans have diabetes—the majority with type 2 diabetes, also known as noninsulin dependent or adult-onset diabetes. Many, although not all, are overweight or obese.
“Some people are able to control their disease through dietary changes, exercise, and careful monitoring of their blood sugar levels,” explained Dr. Ichter. “However, poorly-controlled diabetes over long periods of time can lead to serious health problems including heart disease, stroke, kidney failure, amputations, and blindness.”
The diabetes–bariatric surgery connection
Research has long revealed that weight-loss surgery had the added benefit for diabetics of a lessening of symptoms, and in some cases their elimination.
“Of particular note is the Cleveland Clinic study, STAMPEDE—Surgical Treatment and Medications Potentially Eradicate Diabetes Efficiently—a landmark study that followed diabetes patients for three years after their procedure,” said Dr. Ichter. “These patients lost more weight, had better kidney function, and a better quality of life than diabetes patients who were treated with intensive medical therapy alone.”
Look at the results:
Of the surgery patients, more than one-third of the gastric bypass group and 24 percent of the sleeve gastrectomy group had their blood glucose under control after three years. Just five percent of patients in the medication group achieved that goal.
In addition, more than 90 percent of the surgery patients required no insulin after three years, while nearly half of them needed it at the start of the study. They also reduced their use of cholesterol and blood pressure medications.
It’s not just the pounds that make a difference
“While weight loss alone can help type 2 diabetes, bariatric surgery also positively affects hormones and other substances that regulate insulin and blood sugar,” said Dr. Ichter. “The earlier you get weight-loss surgery after being diagnosed with type 2 diabetes—before the disease progresses—the better the results.”
Despite the benefits, weight-loss surgery is not for everyone. Talk to your doctor about what may be the right choice for you. Click here to learn more about Lancaster General Health’s bariatric program.