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Obesity, Type2 Diabetes and Bariatric Surgery

Obesity, Type2 Diabetes and Bariatric Surgery

Type2 Diabetes

Also known as Diabetes Mellitus, this is the most common form of diabetes. In fact, Type2 diabetes is estimated to account for at least 95% of all diagnosed cases of diabetes. Sadly the cases of diabetes diagnosed Mellitus is increasing alarmingly every year all over the world.

What makes this disease so much more dangerous is that it is considered as one of the leading causes of blindness in adulthood, lower limb amputations, kidney failures, high blood pressure, heart diseases just to name a few of its co-morbidities.


Did you know that diabetes-related complications kill one person in the world every 10 seconds?

Currently, the most common treatment for Type2 diabetes includes anti-diabetes medication, appropriate diet and exercising. While taking the prescribed medication and following a strict lifestyle and dietary change helps keep blood sugar levels from rising too high, sometimes, this is not enough.

Diabetes is a progressive condition that often worsens over time; requiring higher and higher doses of medication to control the blood sugar.


Weight and Type2 Diabetes

Yes, your weight matters. Although not all overweight and obese patients develop diabetes, studies show that a majority of people with excessive weight will develop this disease in their lifetime. It is estimated that over 90 per cent of all the diagnosed cases of Type2 Diabetes are diagnosed in obese and overweight patients.

Obesity is therefore a major contributing factor for diabetes. This means that if you are obese or overweight, you are so much more at risk of developing Type2 Diabetes as compared to another person with what is considered as normal weight.

Obesity stimulates insulin resistance and irritation in the body. As a result, this affects the regulation of glucose in the body.


What can you do?

Studies also show that losing 5-10 percent of excess weight through dieting and exercising reduces the risk of diabetes.  In fact, obese diabetics and obese and overweight people are advised by health experts to lose weight through a total lifestyle change that includes strict dieting and increased physical exercise.

If you are overweight or obese (whether or not you are suffering from diabetes), the best thing you can do for your health is to try as much as you can to lose weight through regular physical exercises and adopting strict diet and sticking to it. This will reduce your risk of developing Type2 diabetes and its complications or help reverse it (if you’ve already been diagnosed with diabetes.

However, sometimes weight-loss can be really difficult to achieve or sustain even with regular exercise and a strict diet. This is especially true for severely obese patients. Sometimes, physical exercise is not an option for some people with chronic joint pain, arthritis and other conditions.

When this is the case, the most effective treatment for obesity and diabetes is Bariatric surgery.


Can Bariatric Surgery really help Improve Type2 Diabetes in Obese Patients?

There are many factors that make it very difficult to treat diabetes especially in both moderately and severely obese diabetics. While some of these people cannot lose weight in the usual way (lifestyle change and exercise), most of those who are able to lose even a little weight tend to gain the weight back in a short time. Hence, there is no sustained weight loss.

Another reason is that anti-diabetic medications sometimes also cause hypoglycemia. This simply means that they cause the sugar levels to fall too low.

Bariatric surgery is very effective in treating diabetes because unlike with traditional weight-loss methods, obese patients and obese diabetics are able to lose so much more weight. With bariatric surgery, patients can lose up to 25 % of their total body weight.

Studies show that an estimated 87 percent of obese diabetics also achieve better control of their glucose levels and consequently need less medication after bariatric surgery. An estimated 78% are able to fully control their glucose levels without taking any medication after the weight loss surgery.


Risks Vs Benefits of Bariatric Surgery as a Treatment Option for Type2 Diabetes

The risks of bariatric surgery are considered to be equal to those of a knee surgery or a gallbladder surgery. According to experts on diabetics all over the world including; International Diabetes Foundation (IDF) agree that the benefits of bariatric surgery far outweigh the risks of living with diabetes and/or severe obesity.

In fact, after the 2nd World Congress on Intervention Therapies for Type 2 Diabetes convened in New York City in 2011 involving endocrinologists, diabetologists ,  surgeons and other health experts, The IDF issued a statement promoting bariatric surgery as a treatment that should be considered early for Type2 diabetes.

According to IDF, bariatric surgery should be an option for obese diabetics who have a BMI that of 35 or above and as an alternative treatment option for obese diabetics with a BMI of 30 to 35 especially if their Type2 Diabetes cannot be adequately controlled by anti-diabetes medication and lifestyle changes.


Types of Bariatric and Metabolic Surgeries and how they can improve Diabetes

  • The adjustable gastric band involves placing a removable band around the upper part of the stomach. Remission rates after this procedure are estimated at 40 to 60 percent. Remission of Type2 diabetes is however thought to be a secondary result of the weight loss that is achieved.

This means that obese diabetics who do not succeed in losing weight with this procedure are also less likely to improve their diabetes.

  • The gastric Bypass alters the digestive system such that food consumed bypasses most of the upper part of the smaller intestine. It causes significant weight loss and up to 80% of patients achieve remission of their diabetes. Diabetes is improved even before substantial weight loss occurs.
  • The Duodenal Switch; though not preferred by many because it is considered potentially more complicated, is also very effective with more than 85% remission rates and long-term improvement of diabetes just a short time after the procedure.
  • The Sleeve gastrectomy involves removal of a big portion of the stomach leaving a smaller portion that aids weight loss. It is estimated that diabetes remission rates after this procedure are at least 60%.

Are you considering any of the above bariatric procedures? If you have any questions at all about weight-loss surgery, do contact us. We will be happy to be of help.

Author Info

Pamela Safi