Weight Loss Surgery for Diabetes: Pros and Cons
Considerations for Gastric Bypass Surgery
Nov 14, 2009
Weight loss surgery for diabetes comes with both risks and rewards. If the doctor thinks that your type 2 diabetes may be caused in part by obesity, gastric bypass surgery may be suggested. There are pros and cons with gastric bypass surgery, and anyone considering surgery should weigh them carefully, talk to their doctor, and make an information decision.
About Type 2 Diabetes
According to the American Diabetes Association, there are 26 million Americans with type 2 Diabetes. Type 2 diabetes occurs when the body's cells no longer respond to insulin, the hormone that regulates blood glucose levels. Normally the body keeps tight control on the amount of circulating blood glucose; if it gets too low or too high, serious illness and complications can result.
Type 2 diabetes is caused by a complex interaction among genetic factors and lifestyle factors. Obesity seems to go hand-in-hand with type 2 diabetes. Many people try to modify their lifestyles when diagnosed with type 2 diabetes. Often doctors recommend eating a healthy diet, exercise, and weight loss for diabetics. If patients are unable to lose weight using lifestyle modification techniques, doctors may recommend gastric bypass surgery or weight loss surgery for diabetes.
What is Gastric Bypass Surgery?
Gastric bypass surgery is major surgery. It involves preparation, a hospital stay, and a lifelong commitment to eating in a new way to accommodate a smaller size stomach. In gastric bypass surgery, surgeons rearrange the stomach and intestines to create a smaller stomach or bypass most of the stomach so that only smaller quantities of food can be consumed, and the food bypasses most of the stomach and goes straight into the intestines. There are several procedures, and only a doctor can recommend appropriate procedures given a patient's overall health and specific conditions.
Weight Loss Surgery for Diabetes: Pros
There's growing evidence that gastric bypass surgery or weight loss surgery for diabetics can drastically improve their blood glucose levels, making it possible to significantly reduce or even discontinue medication. As reported in the Annals of Surgery, a study involving over a thousand patients who underwent gastric bypass surgery resulted in 83% of patients' blood glucose returning to normal levels. This is significant, and an extremely positive outcome. While doctors aren't entirely sure if the results are due to the dramatic weight loss, change in diet, or some combination of this and hormonal changes, anything that can return blood glucose levels to normal is hailed as a very positive step.
Gastric Bypass Surgery Risks
Gastric bypass surgery is not without risks, and patients evaluating whether or not they should undertake weight loss surgery for diabetes should spend time researching and understanding the risks.
The risks of weight loss surgery include:
- infection
- anesthesia risk
- hernia
- bowel obstruction
- malnutrtion
Patients who have gastric bypass surgery must change their eating habits for the rest of their lives. They must follow strict diets, and eat small quantities of food frequently. Going off of their new diet can lead to complications and weight gain. If someone is not totally committed to eating in this new way, they can do serious damage to their health. In addition, some patients end up with malnutrition because their bodies cannot get or absorb enough of particular nutrients on the restricted diet; supplements must be taken for a lifetime.
Type 2 Diabetes Treatment Options
Anyone newly diagnosed with type 2 diabetes should explore all options, especially simple options such as lifestyle modification, before embracing weight loss surgery for type 2 diabetes. Surgery is risky for healthy patients; most patients undergoing gastric bypass surgery are morbidly obese, defined as having a body mass index (BMI) of 40 or greater. Obesity alone raises surgery risks and potential for complication. Surgery is not something to be taken lightly. But if all else fails, and patients realize the risks of gastric bypass surgery, it is one possible way to reduce or reverse type 2 diabetes.
Sources:
- American Diabetes Association
- Mayo Clinic, http://www.mayoclinic.com/health/gastric-bypass/MY00825
- Annals of Surgery, accessed on Pub Med, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360104/
- Cornell University, "Type 2 Diabetes May Be Caused by Intestinal Dysfunction", http://news.med.cornell.edu/wcmc/wcmc_2008/03_05_08.shtml
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