Monday, 27 May 2019

Diabetes and Bariatric Surgery – Healthline

Experts say the surgery can provide more than just weight loss. It can also lower the risk of heart attack and stroke.

Share on PinterestBariatric surgery can be beneficial for people with diabetes but getting insurance to cover the procedure can be difficult. Getty Images

Bariatric surgery may seem like an invasive and risky option for those who are obese.

However, recent research shows that people who are obese and have diabetes may benefit from the surgery in more ways than just weight loss and improved blood glucose levels.

Types of bariatric surgery include:

  • gastric banding
  • gastric bypass
  • gastric sleeve
  • gastric plication
  • duodenal switch
  • incision-free surgeries
  • the Maestro system, which is an implantable device that reduces appetite

In a recent study, researchers reported that “people who were severely obese and had diabetes had 40 percent fewer heart attacks and strokes — and 67 percent fewer deaths — within five years after weight loss surgery.”

The study also found a 50 percent reduction in a person’s risk for diabetic neuropathy in their hands or feet.

“Macrovascular disease is a leading cause of morbidity and mortality for patients with type 2 diabetes,” explained the researchers, “and medical management, including lifestyle changes, may not be successful at lowering risk.”

Most significant, however, is that about half of the people with diabetes who specifically underwent gastric bypass were in diabetes remission for an average of seven years as a result of significant weight loss and improved overall health markers, including blood glucose levels.

The study, published in a recent issue of the Journal of the American Medical Association, was funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

It was researched at four locations: Kaiser Permanente’s Washington, Northern California, and Southern California locations as well as the HealthPartners Institute in Minnesota.

The study consisted of more than 5,000 Kaiser Permanente patients and 247 HealthPartners patients with diabetes who had a body mass index (BMI) of 35 or higher and had received bariatric surgery.

Those patients were then contrasted with a control group of 15,000 people who were obese and have diabetes who received traditional medical care to manage their weight and blood glucose levels.

If you tried to duplicate bariatric surgery with medications, it would probably take a minimum of 18 pills,” said Dr. Mitchell Roslin, director of Bariatric and Metabolic Surgery at Lenox Hill Hospital in New York.

Roslin told Healthline that the benefits of bariatric surgery are far more significant than simply weight loss.

“It lowers blood pressure, reverses insulin resistance, lowers abdominal pressure, changes levels of sex hormones, lowers cholesterol, and changes the gut-brain interaction,” explained Roslin. “Obesity is an inflammatory disease and bariatric surgery reverses this process. Weight loss is partially responsible but not the complete story. Changes in neurological pathways and hormone levels pl