Weight Loss Surgery and Type 2 Diabetes

Type 2 diabetes is a chronic disease where the body is not able to manage blood glucose levels naturally. It is diagnosed when blood sugar levels are too high. It is caused by the pancreas being unable to produce an adequate amount of insulin. It is estimated that over 85% of diabetes cases in Australia are type 2 diabetes. 

Aside from genetic risk factors, the modifiable lifestyle risk factors that are associated with type 2 diabetes are being overweight or obese, having a poor diet, having high blood pressure and high cholesterol.

Can Type 2 Diabetes be cured?

It is accepted that there is no known cure for type 2 diabetes, as confirmed by Diabetes Australia. It is important to note that despite it being incurable, Diabetes Australia issued a position statement confirming that “research shows is it possible for some people to achieve type 2 diabetes remission”*. 

Studies have shown that “after bariatric surgery, blood glucose may return to normal levels without medication in up to three out of four people with type 2 diabetes”

How does weight loss surgery positively affect type 2 diabetes?

Weight loss surgery changes how the body processes and digests food. Procedures such as the gastric bypass reduce the overall intake of food as well as alter the metabolic process. These changes, combined with weight loss and changes in modifiable risk factors can lead to improvements in insulin sensitivity. Importantly, the changes contribute to slowing the progression of type 2 diabetes and can result in an absence of the disease and symptoms altogether.

Gastric banding and type 2 diabetes

Compared to gastric bypass, lap band surgery is not considered to be as effective at resolving the symptoms of type 2 diabetes. This is because it is the least invasive of all weight loss procedures. Unlike gastric sleeve and gastric bypass, lap band surgery uses a silicone band placed around the stomach to reduce the amount of food an individual can consume. The procedure is completely reversible. For individuals with early-stage or less advanced type 2 diabetes, weight loss and improvements combined with lifestyle factors may have a positive effect on the progression of type 2 disease. 

Gastric Sleeve and Type 2 Diabetes

Gastric sleeve surgery is a moderately invasive procedure that removes approximately 75% of the stomach. The digestive pathway is unmodified when compared to gastric bypass surgery. The gastric sleeve has a restrictive effect on food consumption. Individuals who undergo gastric sleeve surgery tend to experience less hunger as the procedure reduces the release of the hormone ghrelin – known as the hunger hormone. While these changes allow individuals to lose 65-70% of excess weight, the procedure’s effects on type 2 diabetes are less profound than with gastric bypass. 

Gastric Bypass and Type 2 Diabetes

Of all the available weight loss procedures, gastric bypass produces the most notable results in terms of weight loss and improvements in type 2 diabetes. This is due to the combined effects of restricting the amount of food an individual can consume. The procedure also limits the amount of nutrients the body can absorb from food. 

Gastric bypass surgery modifies the digestive tract by making the stomach significantly smaller and redirecting how the food travels along the small intestine, the organ responsible for the adsorption of calories. These changes also result in hormonal changes that reduce a person’s hunger and appetite.

Who can benefit from weight loss surgery?

Each case varies and there are several criteria used to determine whether someone is a suitable candidate for bariatric surgery. Generally speaking, for procedures such as the gastric sleeve and gastric bypass, having a Body Mass Index (BMI) of 35 or higher is required. Individuals with a BMI of 30 or higher, may qualify if they have at least one related medical issue. 

If you’d like to learn more about the positive effects of weight-loss surgery on diabetes, you are welcome to book a consultation with Dr Kuzinkovas by calling Advanced Surgicare clinic on 1300 551 533

Dr Vytauras Kuzinkovas is an Advanced Laparoscopic Surgeon and has performed more than 5,000 weight loss procedures. He is actively involved in the training of medical students and surgical trainees. 
*Click here to read the Diabetes Australia position statement on bariatric surgery.

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