Metabolic Surgery for Diabetes – What the latest research tells us.

Approximately 90% of people who have diabetes in the world have type 2 diabetes. In this form of diabetes, the body does not produce enough of the hormone insulin, or the cells in the body do not use insulin properly. Insulin is necessary for the body to be able to use glucose or blood sugar for energy. As a result, glucose builds up in the blood, where it can wreak havoc, instead of going into cells. Complications of diabetes include heart disease, blindness, nerve damage and kidney damage.

How is type 2 diabetes normally treated?

Traditionally, lifestyle changes including losing excess weight, eating a healthy diet and engaging in regular exercise are the first-line treatments for type 2 diabetes. When these modifications do not appear to treat the disease sufficiently, medications can be prescribed. Some medications help the pancreas produce more insulin, while others help the body use the insulin that it produces more efficiently. If these drugs don’t work, a person may need to take insulin. Often these traditional treatments for diabetes do not work and patients run the risks of long term complications. Even with good medical control, some patients still go on dialysis, lose limbs, and have significant heart attacks, drug reactions, and other complications. The notion that medical therapy is without risk is incorrect.

Does metabolic surgery “cure” diabetes?

  Diabetes is poorly understood and medical science cannot claim a “cure”. The aim is to put it in remission, which is defined as normal blood sugar levels and no need for diabetes medication. This means bringing glucose to normal levels and preventing the progression of diabetic complications. Some studies have found that up to 73% of people with diabetes who underwent bariatric surgery combined with conventional therapy achieved remission. By contrast, just 13% of those people who received only conventional therapy went into remission. A landmark 2004 study in JAMA of more than 22,000 people who underwent bariatric surgery showed the following:
  1. Diabetes was completely resolved or improved in 86% of patients.
  2. High blood lipids improved in 70% or more of patients.
  3. High blood pressure was resolved or improved in 78% of patients.
What’s more, a study in the Annals of Surgery showed that 83% people who underwent gastric bypass were in remission of their diabetes. A study in the New England Journal of Medicine found that long-term mortality after gastric bypass surgery was significantly reduced, particularly deaths due to diabetes complications. The bottom line is that metabolic surgery can play a big role in treating type 2 diabetes.

How about type 2 diabetic patients who are not morbidly obese?

There are many people living with type 2 diabetes who are not considered as having obesity, but may be considered as being overweight with a BMI range of 27 to 35. It is possible that metabolic surgery may benefit even people with diabetes who are not overweight or obese. Each person is to be assessed by our surgeon to determine if they are candidates for metabolic surgery as a treatment for type 2 diabetes. Click here for a summary of RECOMMENDATIONS and GUIDELINES from the 2nd Diabetes Surgery Summit