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Type 2 Diabetes and Surgical Solutions

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Posted: May 16, 2017

Some patients with Type 2 Diabetes may find that surgery may be the solution to diabetic situation.
Pixaby(TeroVesalainen)

Pixaby(TeroVesalainen)

A worldwide growing health concern is Type 2 Diabetes (T2DM). Unlike other diseases, T2DM does not have a known cure such as drugs or surgeries that completely treats the problem. T2DM can be controlled using one or multiple medicines, but even these do not phase out the disease. A question that has been pondered by researchers is whether weight loss surgery is a “solution” for T2DM. A few research studies have been done to find this out. Before learning how surgery may resolve T2DM, it is important to understand what T2DM is and how it effects the body.

T2DM is a disease where the amount of glucose, a type of sugar, in the blood is too high. Medicines like insulin and certain oral medications help to control blood glucose. T2DM is a risk factor for other health concerns such as heart disease and kidney disease. In addition to family history, one of the main risk factors for T2DM is being overweight or obese. Although no cure exists for T2DM, there is a surgery that may resolve both T2DM and excess body weight.

According to current research, the surgery that has been found to help resolve T2DM is weight loss surgery. For a person with T2DM to be eligible for this surgery, he or she must have a BMI of 35 kg/m² or higher. There are different types of weight loss surgeries that can be done, but they all cause decreased appetite and food intake which leads to weight loss. One of the most common is gastric bypass where a small pouch of the stomach is created and only a portion of the small intestine is used. Among the other types of weight loss surgery, gastric bypass was found to be more successful at reversing diabetes. More research studies are needed to understand why one surgery is better than another at reversing T2DM.

Weight loss surgery affects a person’s lifestyle through their diet. It is possible to lose weight by changing eating habits alone, but for many people it is hard for them to take control of their eating and weight loss surgery assists them with making a difficult lifestyle change. As with any surgery, there are risks and benefits. Risks may include stomach ulcers, strictures (narrowing preventing passage of food), internal adhesions, becoming malnourished, and possibly death although very rare for this specific surgery. Benefits may include improved self-esteem, reduction in joint pain, improvement in heart/kidney health, and increased fertility. The surgery may resolve other health concerns such as sleep apnea and T2DM.

Most of the studies found that the remission of T2DM after surgery can last anywhere from two to five or more years. According to the American Diabetes Association, diabetes is considered “cured” when remission lasts more than five years. There are a few factors that impact both the remission and recurrence after surgery. These include the type of surgery used, the severity and duration of diabetes at the time of surgery, and length of follow-up with health care providers and a registered dietitian/nutritionist.

Because of the reduction of body weight post-surgery, the body gains better control of blood glucose. The production and usage of insulin becomes restored. Overall decreased food intake along with a restricted carbohydrate diet also impacts the control of blood glucose. This process can reverse T2DM resulting in the dismissal of medicines. Reducing excess body weight can also reduce the likelihood of other diseases and health concerns.

Weight loss surgery may be the solution for T2DM. Only a few research studies have been done on surgery as a solution for T2DM, but to date all the studies have found that weight loss surgery improves blood sugar levels and possibly reverses T2DM. It is unknown if these results are short lived or long term. More research studies are needed to know whether or not the weight loss surgical “solution” has lasting effects long term.

Written by dietetic intern Samantha Gogets