Published:
August 29, 2022
If you have type 2 diabetes, guidelines backed by the American Diabetes Association and 44 other respected health organizations say weight-loss surgery could be a treatment option to consider—even if you are just mildly 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 severely obese, with a BMI (body mass index) of at least 40, regardless of their overall blood sugar levels. Improvement in their diabetes was a welcomed side effect.
More recent guidelines, however, 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: An Increasingly Common Disease
Nearly 26 million Americans have diabetes—the majority with Type 2 diabetes, also known as non-insulin 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. 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 an added benefit for diabetics—reducing, and in some cases eliminating symptoms. 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. 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. Take a look at the results:
- A control group treated with medications, daily blood-glucose monitoring, intensive counseling about diet and exercise, and regular weigh-ins, lost an average of 9 pounds.
- A group undergoing gastric bypass, which converts the stomach into a small pouch and bypasses the first portion of the intestine, lost an average of nearly 58 pounds.
- A group undergoing sleeve gastrectomy, which removes 80 percent of the stomach, lost an average of 47 pounds.
Of the surgery patients, more than a third of the gastric bypass group and 24 percent of the sleeve gastrectomy group had their blood glucose under control after three years. Just 5 percent of patients in the medication group achieved that goal.
In addition, more than percent of the surgery patients required no insulin after three years, while nearly half needed it at the start of the study. They also reduced their use of cholesterol and blood pressure medications.
It's More Than the Pounds
While weight loss alone can help type 2 diabetes, bariatric surgery also positively affects hormones and other substances that regulate insulin and blood sugar. Therefore, 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.