Is Weight-Loss Surgery a "Cure" for Type 2 Diabetes?
Diabetes Forecast on what’s known about bariatric surgery – and what is not
More and more reports have been surfacing about weight-loss surgery "curing" type 2 diabetes. At the same time, more and more questions are being asked about this process, how it works, who it works for, and how long it may continue to work. While research and studies that will lead to definitive answers may take years, the March issue of Diabetes Forecast, the consumer magazine of the American Diabetes Association, provides the latest information on weight-loss surgery and type 2 diabetes — and poses additional questions that need to be answered.
What is weight-loss surgery? Also known as bariatric surgery, it refers to several procedures that reconfigure the digestive system. In the United States, the most frequently performed type is gastric bypass surgery, which shrinks the stomach (from the size of a fist to that of a thumb) and shortens the path food takes through the small intestine — thereby limiting the number of calories absorbed. A second popular type of bariatric surgery is known as "lap-banding," in which a liquid-filled belt is wrapped around the stomach. The belt’s tightness can be adjusted by adding or subtracting saline solution through a port just under the surface of the skin. This belt cinches the stomach so that it will feel full with less food. There are other types of bariatric surgery, and even more are in experimental stages.
How does bariatric surgery work for people with type 2 diabetes? There is no easy answer for this, although an analysis of more than 600 studies shows that 78 percent of patients had a complete resolution of their diabetes after surgery, with bypass procedures being more effective than procedures that only “shrink” the stomach. Although blood glucose levels tend to improve with weight loss of any means, the improvement with surgery occurs strikingly quickly and may be out of proportion to the weight loss. This may have something to do with the rearranged anatomy, but researchers are not sure exactly what to thank — the GLP-1 hormone, the suppression of an agent that spurs the development of high blood glucose, or the shortened digestive tract, leading to less contact with food.
While the quality of data available regarding bariatric surgery does not yet meet the highest standards, there is a general agreement that it should be an option for severely obese people with diabetes. The American Diabetes Association currently recommends considering bariatric surgery for people with type 2 who have a body mass index (BMI) of 35 and over. Both expert opinions and published research are divided when it comes to people with lower BMIs and people under the age of 18.
What is life like after bariatric surgery? A sub-feature in this article includes the real-life perspectives of four women who have undergone different types of bariatric surgery. They talk about what has improved and what has worsened, and share some eye-opening side effects to keep in mind.
While bariatric surgery may be an exciting option for severely obese people with type 2 diabetes, there is still much to be learned about the process and its long-term effects. The time-tested approach to diabetes care for most people remains diet, exercise, and medication — the gold standard for diabetes care.
The March issue of Diabetes Forecast also features an interview with Brad Wilk – best known as the drummer for Rage Against the Machine – who was diagnosed 12 years ago with type 1 diabetes. He shares his thoughts on his diagnosis, testing blood glucose mid-performance, close calls while on stage, his future projects, and his family. “Be proud of who you are, and don’t let this disease keep you from doing what you want to do – unless, of course, you want to be a professional pie-eating contestant. [In that case] I would say find another passion.”
Also featured in this issue of Diabetes Forecast:
- Potluck Recipes – hearty entrées that will make you the star of the party.
- On the Alert – a mother-daughter couple share why American Diabetes Association Alert DaySM (which falls on March 23rd this year) is important to both of them, the mother with type 2 diabetes and her daughter with type 1.
- Weekend Getaway – how 45 families in Seattle come together to build community while educating parents and entertaining kids.
Diabetes Forecast has been America's leading diabetes magazine for more than 60 years, offering the latest news on diabetes research and treatment to provide information, inspiration, and support to people with diabetes.
The American Diabetes Association is leading the fight to Stop Diabetes and its deadly consequences and fighting for those affected by diabetes. The Association funds research to prevent, cure and manage diabetes; delivers services to hundreds of communities; provides objective and credible information; and gives voice to those denied their rights because of diabetes. Founded in 1940, our mission is to prevent and cure diabetes and to improve the lives of all people affected by diabetes. For more information please call the American Diabetes Association at 1-800-DIABETES (1-800-342-2383) or visit www.diabetes.org. Information from both these sources is available in English and Spanish.