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Healthy Living

How Bariatric Surgery Can Help People with Diabetes

Jun 1 2021

Managing your weight is an important part of controlling diabetes. Not only does being overweight increase your risk of developing diabetes, but losing weight decreases your risk of complications like kidney and heart disease. In some cases, people who lose weight are able to stop taking diabetes meds.

Simple changes to your diet and exercise plans may be all it takes to get your weight to a healthy range. When that doesn’t work, it may be time to check out other options like weight loss surgery. If you have a BMI of 35 or greater and have diabetes, you can qualify for weight loss surgery. It could help you lose weight and reduce complications from diabetes.

What the research says about weight loss surgery and diabetes

Research suggests that weight loss surgery offers key benefits to diabetics. We already know that patients who go through weight loss surgery can lose up to 25% of their total body weight within one year after the surgery. That alone could help diabetics who have not been able to lose weight through diet and exercise.

The benefits for diabetics go beyond weight loss. Researchers looked at more than 5,000 patients who chose weight loss surgery and compared them to people who opted for other methods to control the disease. Those who had weight loss surgery had a lower risk of heart attack, stroke and diabetic neuropathy. They also had 67% fewer deaths than the control group.

Here’s how it works

Although we know that losing weight is helpful for diabetics, we aren’t entirely sure why weight loss surgery is so effective. One theory is that the lower calorie intake and weight loss help the body cut back on the amount of insulin it makes. A similar theory proposes that surgery affects the hormones that play a role in insulin sensitivity.

Another reason may be the effect of some weight loss surgeries on gut hormones. Altering the small intestine changes the way the body absorbs carbs and fat. Bypassing the duodenum may help lower blood sugar levels. This may explain why doctors notice the greatest benefits in people who had specific types of weight loss surgery.

Bariatric surgery and diabetes remission

Weight loss — no matter how it’s achieved — can lead to remission. It should be no surprise to see this in patients after weight loss surgery because of the amount of weight they lose. Patients who had weight loss surgery lost nearly 21% of their body weight, compared to the control group that lost just under 2% of their body weight.

A study of 60 diabetics highlighted the relationship between weight loss surgery and remission. Of the patients studied, the weight loss surgery group had a 73% rate of remission. The rate for the control group was just 13%. Even those who did not reach full remission benefitted from the surgery. More than three-fourths of the patients were able to stop taking meds.

Is weight loss surgery a cure for diabetes?

Researchers can’t say for sure that weight loss surgery is a cure for diabetes. Most of the studies done so far come from observations made by doctors. They didn’t use randomized control groups and did not follow up with patients to check the long-term effects.

Types of bariatric surgery

Gastric sleeve is the most common type of bariatric surgery in the United States, but it’s not the only one. Doctors perform several types of bariatric surgery , including the following:

  • Adjustable Gastric Band: The doctor places a silicone device around part of the stomach to reduce the amount of food you can eat.
  • Biliopancreatic Diversion with Duodenal Switch (BPD/DS): During surgery, the doctor reduces the size of the stomach and reroutes the small intestine.
  • Gastric “Sleeve”: The doctor takes out 80% of the stomach so it holds less food.
  • Roux-en-Y Gastric Bypass: The procedure is like BPD/DS, but the doctor leaves more of the small intestine in place.
  • Single Anastomosis Duodeno-Ileal Bypass with Sleeve: This is like BPD/DS, but it requires fewer connections to the small intestine.

Patients who choose gastric bypass or BPD/DS appear to see more benefits than those who opt for a surgery that only makes their stomachs smaller. This may be because bypassing the small intestine lowers how much fat the body absorbs.

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