Weight Loss Surgery: Paving ways to Diabetes Remission...
We are eating ourselves into a diabetes epidemic. This was reported by the Center for Disease Control, who is becoming increasingly concerned about the staggering figures that prove the marked association between obesity and diabetes. In 1999, there was a 20% increase in the number of obese individuals compared with the previous year and a massive 40% increase in the incidence of diabetes during the same period.
Diabetes, characterized by the presence of elevated blood sugar levels, is a serious and a possibly debilitating condition. And the Center for Disease Control is truly not pleased with the large number of obese individuals who have diabetes or those, who may have diabetes soon.
The Link Between Obesity and Diabetes
Obesity is inarguably linked with diabetes. Among ALL individuals diagnosed of having diabetes, 80% to 90% are also obese. Until now, confusion on how obesity leads to diabetes remains. And it is a fact that not all diabetics are obese, neither are all obese individuals diabetics. However, in many research studies, scientists have observed that most obese diabetics are resistant to insulin, a hormone that reduces sugar in the body. This means that insulin can no longer have any effect on the cells, leading to a chronically elevated blood sugar.
The problem with diabetes is that because of high blood sugar, the blood becomes very think and impairs delivery of nutrients to different organs in the body. And in unrelieved stages, it may lead to multi-organ failure. That is why many obese diabetics fear that one day, this may be something that they will have to face.
Weight loss Surgery for Diabetes
Fortunately, growing evidence on the use of bariatric surgery and even other types of weight loss surgeries suggest that obese individuals might no longer have to be diabetics. For the past years, the safety and efficiency of bariatric procedures have significantly improved. Patients experience very few complications. Mortality rates are low of about less than 1%, and its effects on diabetes have indeed been revolutionary.
A case study involving an obese patient with uncontrolled diabetes mellitus revealed that a year after undergoing weight loss surgery, Roux-en-Y gastric bypass (RYGB), the patient lost 30% of his weight, no longer took cholesterol-lowering meds and was completely free from diabetes. These results were further proved by another study involving 30 obese diabetics. After another type of weight loss surgery, Laparoscopic Adjustable Gastric Binding (LAGB), a whopping 22 subjects or about 73% of all 30 subjects achieved diabetes remission. Because of the unbelievable success of modern weight loss surgeries, diabetes no longer seems to be irreversible.
How it happens...
Some sceptics may think that this unparalleled success in diabetes treatment might just because of a pure and simple stroke of luck. However, the truth is, these studies have been grounded on a sound knowledge on the basic physiology of the body.
Weight loss surgeries have been proven to increase the release of hormones that promote insulin production and at the same time increase sensitivity of the cells to insulin. Randomized controlled studies demonstrate that several years after surgery, there is a marked increase in insulin sensitivity as well as a decrease in lipotoxicity/inflammation.
These positive results are certainly hard to discredit. In fact, many experts even suggest that weight loss surgery might just be a safe and effective means of losing weight and may offer an excellent solution not only for diabetes but for a vast number of other obesity-related conditions.
Its only danger is that because of its dramatic effects, people might resort to weight loss surgeries as an “easy” way out. Often forgetting that even after weight loss surgery, you have to work hard to make healthier choices and live a healthier lifestyle. This is the most common reason why some patients start gaining weight several years after losing a lot. Weight loss surgery is not an “end”. You still have to live a life after it. And to do that, you have to make extra sacrifices to maintain your new and healthier body.
References:
- Bose M et al. Weight loss and incretin responsiveness improve glucose control independently after gastric bypass surgery.
- Camastra S et al. [Bariatric surgery as a treatment of type 2 diabetes]. Recenti Prog Med. 2011 Feb;102(2):82-7
- Colucci RA. Bariatric surgery in patients with type 2 diabetes: a viable option. Postgrad Med. 2011 Jan;123(1):24-33.
D E Cummings Endocrine mechanisms mediating remission of diabetes after gastric bypass surgeryAnti-diabetic mechanisms of gastric bypass International Journal of Obesity 33, S33-S40 (April 2009) |doi:10.1038/ijo.2009.15 - Dixon JB, O'Brien PE, Playfair J, et al Dixon JB, O'Brien PE, Playfair J, et al Adjustable Gastric Banding and Conventional Therapy for Type 2 Diabetes: A Randomized Controlled Trial JAMA. 2008;299:316-323
- Harvey EJ et al. Hormone changes affecting energy homeostasis after metabolic surgery. Mt Sinai J Med. 2010 Sep-Oct;77(5):446-65.
- Hoerger TJ et al. Cost-effectiveness of bariatric surgery for severely obese adults with diabetes. Diabetes Care. 2010 Sep;33(9):1933-9.
- http://www.diabeticcareservices.com/diabetes-education/diabetes-and-obesity
- Huang CK et al. Laparoscopic Roux-en-Y Gastric Bypass for the Treatment of Type II Diabetes Mellitus in Chinese Patients with Body Mass Index of 25-35. Obes Surg. 2011 Apr 9. [Epub ahead of print]
- Nora M et al. Metabolic Laparoscopic Gastric Bypass for Obese Patients with Type 2 Diabetes. Obes Surg. 2011 Apr 22. [Epub ahead of print]
- Perugini RA, Malkani S.Remission of type 2 diabetes mellitus following bariatric surgery: review of mechanisms and presentation of the concept of 'reversibility'. Curr Opin Endocrinol Diabetes Obes. 2011 Apr;18(2):119-28.
- Raj PP et al. Bariatric to metabolic surgery: management options and experience at a tertiary centre. J Indian Med Assoc. 2010 Oct;108(10):645-7.
- Villamizar N, Pryor AD. Safety, effectiveness, and cost effectiveness of metabolic surgery in the treatment of type 2 diabetes mellitus. J Obes. 2011;2011:790683. Epub 2010 Nov 14.






