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Most type 2 diabetes patients are told to make lifestyle modifications as a treatment for the disease. A certain subset of patients can benefit from weight loss surgery, however.

Treatment for type 2 diabetes, at least at first, involves making lifestyle modifications, including losing weight, exercising, and eating a healthier diet. Some patients with type 2 diabetes might also be prescribed medication such as insulin or metformin. One other treatment method for obese patients with severe type 2 diabetes is bariatric surgery, better known as weight loss surgery.

Studies have shown that weight loss surgery can help type 2 diabetics control their blood sugar levels, and many people experience a normalization of their blood sugar levels. This means that patients will either need much less or no medication after surgery.

Studies have concluded that weight loss surgery can benefit patients in multiple ways:

  • Six years after weight loss surgery, 62 percent of the 400 people that participated in one study had no signs of diabetes. Only six to eight percent of people who took medication but didn't undergo surgery had the same results.
  • Patients had improved blood pressure, cholesterol and fat levels.

So, who qualifies for bariatric surgery?

Not everyone is a good candidate for weight loss surgery. Most doctors will consider two criteria, which are:

  • BMI. Patients with a BMI of 35 or higher might be eligible for weight loss surgery.
  • Lack of success in weight loss. Patients who have tried to lose weight but are not able to do so or are not able to keep off the weight successfully may be considered eligible for the surgery.

Before you actually undergo the surgery, your doctor will do a detailed check-up to determine a number of things, including:

  • Whether you are physically healthy enough to undergo the operation.
  • Whether you are emotionally ready for the operation and ready for the changes you will have to make, including eating much less, having a healthy diet and exercising as part in your post-surgery life.
  • Whether you have any other complications that may make you ineligible for weight loss surgery such as heart disease.

What are the different types of surgeries you can undergo?

Several different kinds of surgeries can be performed with the ultimate goal of helping you lose weight. 

Gastric bypass

A gastric bypass involves making a small pouch in the stomach which divides the top portion from the remaining part. When you eat, the food goes into the small pouch and past the top part of the small intestine. This helps you feel full faster and means you absorb fewer calories. This can be quite beneficial as studies have shown that up to 80 percent of people who undergo a gastric bypass don’t have signs of diabetes post-surgery. However, some disadvantages of this technique include that your body is not as able to absorb the vitamins and minerals that are needed for the functioning of your body. Also, this surgery is not reversible.

Gastric sleeve

A gastric sleeve involves the removal of a large section of your stomach. Patients who undergo the surgery have less room for the food they consume, helping them feel full quicker. Studies have shown that more than 60 percent of people who undergo the gastric sleeve procedure have no signs of diabetes after their surgery. However, this is another surgery that can’t be reversed and again, your body is not as efficient at absorbing vitamins and minerals as it was before, leading to potential health problems.

Adjustable gastric band

An adjustable gastric band procedure involves putting an inflatable band at the top of your stomach, which forms a small pouch where the food enters (similar to a gastric bypass). Again, this causes the patient to feel full faster. The advantages of this type of surgery are that, unlike the other surgeries, the surgeon doesn’t have to cut any part of the stomach or move the intestine, leading to fewer complications down the road. Furthermore, your band can be adjusted or removed later, so the surgery is reversible. Forty-five to 60 percent of people who undergo an adjustable gastric band procedure become diabetes-free. However, studies have shown that patients lose less weight compared to the other procedures and sometimes, the band can slip.

Biliopancreatic diversion

Biliopancreatic diversion is a much less common type of weight loss surgical procedure as it is much more complicated. It involves taking out a large part of your stomach and changing the way the food travels through your intestine. It is actually the most effective surgery for patients with diabetes. Unfortunately, you are also more likely to experience complications with this type of surgery and because you are not absorbing as many calories, it can lead to significant health problems.

Electric implant device

Patients can get an electrical device put in underneath their abdominal skin, which sends signals to the brain in to reduce feelings of hunger. This is beneficial as it is considered a very minor surgery and the device can be removed after you have achieved weight loss. However, patients may experience pain, heartburn, nausea, chest pain and other side effects

Gastric balloons

Gastric balloons are devices that are put into your stomach through the mouth for approximately six months. These gastric balloons help patients lose weight by occupying space within the stomach. You are no longer able to eat the same amount and feel full quicker. The advantages include that it is an easy procedure to perform and it is less expensive.

Conclusion

As a type 2 diabetic who is obese and has struggled to lose weight, you may be eligible for several different weight loss surgeries. Talk to your doctor about your options.

  • Buchwald, Henry, et al. "Bariatric surgery: a systematic review and meta-analysis." Jama 292.14 (2004) 1724-1737.
  • Sjöström, Lars, et al. "Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery." New England Journal of Medicine 351.26 (2004) 2683-2693.
  • Mingrone, Geltrude, et al. "Bariatric surgery versus conventional medical therapy for type 2 diabetes." New England Journal of Medicine 366.17 (2012) 1577-1585.
  • Photo courtesy of SteadyHealth

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