It is well known that obesity contributes to the development of diabetes and that losing weight can improve your blood sugar numbers and the outcome of your diabetes. The Centers For Disease Control report that even a 5% to 7% loss in bodyweight can yield significant improvements in insulin sensitivity, decrease the need for diabetes medications, and actually delay or prevent the onset of type 2 diabetes.
While armed with this knowledge, it may still be difficult for some to lose enough weight to make any difference to diabetes. In fact, contrary to misconceptions about the obese, for many of them losing weight is a lifelong battle. It is not always a mind over matter situation, or a matter of willpower. Many obese people have tried hundreds of times with many different diets to lose weight and keep it off, but are unable to attain lasting results.
The obese often need help. Fortunately, several types of bariatric surgeries have been developed that can make drastic changes in your weight so as to reverse the effects of type 2 diabetes and reduce risks for the many other implications of both obesity and diabetes, such as heart disease, stroke and premature death.
What is bariatric surgery?
Bariatric surgery is weight loss surgery done on the stomach to help you lose weight. There are several types of bariatric surgery you can have. One of them is called a gastric bypass. In this type of surgery, the surgeon stitches across the upper part of the stomach so that the lower part of the stomach has no access to food. The upper part of the stomach is called the pouch and can only hold about one ounce of food at any given time. The next step in the surgery is for the surgeon to connect the jejunum, a part of your small intestine, to the pouch so that food goes from being eaten to the pouch (which is very small) to the jejunum and eventually out of your body. Another feature that makes gastric bypass so successful in helping the obese to lose weight is that it prevents some of the calories from food from being absorbed by the body.
A second type of bariatric surgery is called the Lap-Band surgery. In this surgery, a doughnut shaped sleeve of plastic is inserted so as to encircle the stomach. It is cinched so that a small upper pouch exists and a larger second pouch exists. Food goes from the first part to the second part very slowly through a narrow hole made by the doughnut. This causes you to take in less food at any given time but does not interfere with the absorption of the food once you get it down. Because the upper pouch is so small, you cannot eat very much at a time. The last method, gastric banding, is used when other diet & exercise methods have failed. Generally designed for people with the highest BMI's, it is the least invasive surgery of its kind and is completely reversible, with another "keyhole" operation. Gastric banding is performed using laparoscopic surgery and usually results in a shorter hospital stay, faster recovery, smaller scars, and less pain than open surgical procedures. Because no part of the stomach is stapled or removed, and the patient's intestines are not re-routed, he or she can continue to absorb nutrients from food normally. Gastric bands are made entirely of biocompatible materials, so they are able to stay in the patient’s body without causing harm.
Can diabetes be cured with bariatric surgery?
Diabetes isn’t a disease that can be turned on or turned off. If you have the tendency toward insulin resistance and type 2 diabetes, the tendency will always be there. Even if you have bariatric surgery, if you fail the surgery and gain weight, the diabetes will still be present. Bariatric surgery can only help your system to behave in a non-diabetic way through its drastic effect on weight loss. You can’t really cure diabetes but you can control it very well through eating healthy, losing weight and keeping the weight off.
The STAMPEDE STUDY
About three years ago, a landmark study began at the Cleveland Clinic that’s goal was to test the long-term control of type 2 diabetes because of significant weight loss.
The STAMPEDE trial is one of the largest randomized trials that featured one of the longest subject follow-up periods to compare medical therapy with bariatric surgery.
At the three-year mark, the results showed that 37.5% of the patients who had gastric bypass surgery and achieved significant weight loss were able to reach target blood sugar reading without the use of diabetes medications as compared to the other two groups one that used medical therapy only and the other that had a sleeve gastrectomy.
To make it even more interesting, the study used a more aggressive target to define blood sugar control than the one used by the American Diabetes Association, with a hemoglobin A1C of less than or equal to 6%. Bariatric surgery isn’t a cure for diabetes but it can do a great deal to make it better. It should be something to think about if the normal habits of diet and exercise are unable to help you lose weight.
The surgery is done by specialized bariatric surgeons and supported by health care professionals like nutritionists that can teach you the best ways of eating after having the surgery. You’ll need to severely restrict the amount of food you take in so it needs to be quality food for good health. It is possible for you to stretch out the pouch if you don’t continue to take in small meals; this could result in an increase in food intake and a return of the diabetic symptoms.
We’re Here for You!
Yes, there’s a lot to learn about living well with diabetes. Getting in control might take some time. It’s going to mean making some changes in your life, but you can start with small changes, and you don’t have to make them all at once. And you don’t have to do it alone. If you have any questions, join us in the community and ask.
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