Bariatric surgery (Gastric Bypass or Laparoscopic Gastric Banding) is sometimes considered for adults with a body mass index (BMI) above 35 and type 2 diabetes, especially if the diabetes is difficult to control with lifestyle changes and medicines.
Although small trials have shown benefits to blood glucose control in patients with type 2 diabetes and high BMI, there isn't enough evidence for people with BMIs lower than 35.
There are two main types of bariatric surgery:
Gastric bypass surgery: shrinks the stomach (from the size of a fist to that of a thumb) and shortens the path food takes through the small intestine. This limits the number of calories absorbed. This change is permanent.
Laparoscopic Gastric Banding also known as “Lap-banding”: a belt is wrapped around the stomach. This belt cinches the stomach so that it will feel full with less food. This change can be adjusted or reversed if needed.
Because bariatric surgery is not regarded as a cure, it is recommended that individuals who have undergone a bariatric procedure continue to have the regular screenings that are recommended for people with diabetes, whether or not their glucose levels have normalized.
In addition, they need careful ongoing assessments of blood glucose control conducted by their health care provider, as those with normal blood glucose levels after surgery are at risk for a return of hyperglycemia.