The question of bariatric surgery and reversal of diabetes is an interesting one - weight loss surgery has been seen to improve the symptoms of type 2 diabetes, so whilst it does not exactly ‘reverse’ the condition, there are confirmed reports of the surgery bringing about monumental positive changes to individuals with diabetes. However, the conversation around bariatric surgery and the reversal of diabetes can be misguided and influenced by conflicting studies.
While there is no cure for diabetes, there are instances where bariatric surgery has been seen to decrease the adverse symptoms of the condition and increase the quality of life for those with type 2 diabetes. In this article, Central Coast Surgery will discuss the evidence surrounding how does bariatric surgery reverse diabetes and how there can be a better way of describing the benefits of the surgery for individuals with type 2 diabetes.
What is Type 2 Diabetes?
So before getting to the discourse around “How does bariatric surgery reverse diabetes?”, let’s go over the condition of diabetes. Type 2 diabetes is a health condition in which the body becomes resistant to the normal effects of insulin. Over time, the pancreas loses the capacity to produce enough insulin at all. There are strong genetic risk factors involved in the diagnosis of type 2 diabetes, as well as changeable lifestyle risk factors.
The condition is managed through a combination of regular exercise, eating healthy, and weight loss. Type 2 diabetes, in some cases, is progressive, so individuals with the condition will need oral medications and insulin injections coupled with lifestyle changes.
There is currently no exact ‘cure’ for type 2 diabetes. Instead, those with diabetes can effectively manage the condition through lifestyle modifications, medication, or surgery. Managing diabetes is the best way to prevent further diabetes-related complications.
Types Of Bariatric Surgery
Bariatric surgery is a generic term for weight loss surgery. There are several types of weight loss surgery that are frequently completed in a minimally invasive way. Laparoscopic surgeries involve only a tiny incision and minuscule instruments. The most common types of bariatric surgery are:
- Gastric Sleeve Surgery
- Gastric Bypass Surgery
- Gastric Band Surgery
Bariatric Surgery and Reversal of Diabetes
It is important to note that bariatric surgery does not cure a patient with diabetes type 2. What it does do, is get haemoglobin A1C levels back to an average level without the need for glucose-lowering medication. When this occurs, some refer to this as a state of diabetes remission. At this stage, it is not considered a reversal of the condition, but an important way of mitigating the adverse effects of the condition.
What is Diabetes Remission?
Diabetes remission refers to the period where active disease and symptoms are absent. For diabetes, this can often refer to reaching a blood sugar level that does not require further medical treatment. There is significant importance placed on weight loss as a factor in inducing this ‘remission’ period, whether through surgery or otherwise. Studies in America have found that bariatric surgery in overweight patients also carries benefits independent of weight, and the connection between that and diabetes remission is still being researched.
Preventing Diabetes Type 2 Through Surgery
A better way of understanding the relationship between bariatric surgery and diabetes is that when supported with significant lifestyle adjustments, bariatric surgery can reduce the progression to type 2 diabetes in obese individuals. The importance of a healthy and balanced lifestyle is still the most significant factor in helping to prevent diabetes in patients, and bariatric surgery is not the silver bullet to prevention or recovery.
Diabetes Following Bariatric Surgery
Improvement from the conditions associated with diabetes is more prevalent amongst individuals who have a form of diabetes that does not require medication and who have had the condition for less than five years. For patients who experience more weight loss following surgery, an improvement from diabetes is also more frequent.
Results of Bariatric Surgery Compared to Standard Treatments for Diabetes
Increased Weight Loss
Patients who undergo successful bariatric surgery, on average, lose far more bodyweight than patients who undergo standard treatment as part of an intensive lifestyle change program. Bariatric surgery, such as a gastric band, can often lead to a significant reduction in visceral fat, that is, the fat around internal organs, which contributes to serious blood sugar processing issues.
Lowered Dependence on some Diabetes Medications
In the years following successful bariatric surgery, most patients no longer require the use of blood sugar-lowering medication. The lowered dependence on medication carries the additional benefit of reducing all costs associated with buying medicine. Whilst the procedure itself is expensive, the costs will be recovered in the first year from the savings in not requiring medicines or insulin.
Improved Cholesterol and Blood Pressure Levels
Individuals who undergo bariatric surgery will see their blood pressure fall to healthier levels and a ‘good’ cholesterol rise of HDL to more standard levels.
Lowered Chances of Significant Medical Emergencies
The risk of heart attacks, strokes, and heart and kidney failures are all significantly lowered following bariatric surgery. Whether this is considerably more than via other treatments is not clear. However, the positive effects of the surgery remain substantial.
The speed with which type 2 diabetes side effects are minimised differs between the different types of bariatric surgery. However, some bariatric surgeries are more effective than others for different patients. Consult with your doctor about which type of surgery will be most effective for you.
Will Bariatric Surgery Help Everyone with Diabetes?
It is important to be realistic when it comes to weight loss surgery. Everyone’s goal to lose weight happens at a varied pace and is influenced by several factors outside of the surgery itself. There must be sustained follow-up with the dedicated health care team to assess and adjust the treatment where necessary to prevent complications in patients.
Bariatric surgery will not be the sole cure for each individual’s weight concerns. The risks, benefits and suitability for surgery must be assessed on a case-by-case basis. Beyond an individual having diabetes alone, there needs to be a throughout assessment of other factors, including medical history, social environment and current lifestyle, weight ambitions, and preparedness to make significant changes to dietary and exercise habits.
Bariatric surgery is confirmed to show improvements in some patients with pre-existing diabetes, but not everyone. You must consult with your doctor about your unique circumstances and how the different types of bariatric surgery will affect you.
Bariatric Surgery Reverses Type 2 Diabetes: Bottom Line
Knowing what we know now about bariatric surgery and the reversal of diabetes, it is imperative to recognise this is still an expanding field of study. There are constant advancements in the efficacy of bariatric surgery and the improvements it makes to patients with type 2 diabetes.
Obesity and diabetes are chronic diseases and will have lasting effects with or without surgery. In short, surgery might bring about more significant short-term weight loss than lifestyle changes on their own. Surgery is expected by medical professionals to bring some standard of ‘remission’ of diabetes in most patients. But all patients will require long-term follow-ups to ensure healthy behaviours become habits.
Individuals with diabetes will benefit from speaking to a doctor about how bariatric surgery may bring about a positive change in their condition. The surgical option makes sense in situations where diabetes is harder to control in patients despite meaningful attempts at a positive shift in lifestyle.
Bariatric Surgery and Your Weight Loss Journey
In conclusion – it is evident that there is no clear answer to “How Does Bariatric Surgery Reverse Diabetes?”. ‘Reversal’ is a contested definition in itself, and the effects of bariatric surgery are varied from patient to patient. What is clear, is that in suitable candidates, bariatric surgery can be of substantial assistance in managing conditions surrounding diabetes.
Bariatric surgery is a last resort for weight loss, and despite the effects of diabetes, treatment should be sought through positive lifestyle changes and diet before surgery.
If you are considering any form of bariatric surgery and you have diabetes, the best step is to book a consultation with Dr Ken Wong. At Central Coast Surgery, we work with each of our patients from their very first consultation, right up until they achieve their own post-surgical health and weight-loss goals.
Bariatric surgery is not the cure for diabetes. It is part of a comprehensive treatment program to lessen the conditions around diabetes that help improve quality of life. To see if you are a good candidate for bariatric surgery, give our team a call at (02) 4323 7000 today or online. Dr Wong and the team at Central Coast Weight Loss Surgery happily treat patients from the Central Coast, Newcastle, and Sydney.