Impact on Type II Diabetes of Weight-Loss Surgery
Although we have discussed this topic quite a bit, it deserves attention as it is a growing problem. Statistics tell us that two-thirds of all Americans are overweight or obese today and type II diabetes is affecting 15-20% of this population. Its incidence is responsible for some medical problems like blindness, vascular and heart disease, kidney failure, nerve pain, ulcers in the lower legs, and necessary amputation of limbs–legs in particular.
In the past, medical treatment has centered on weight loss, diet control, and oral medication. As the disease progresses, however, over time more oral medications are indicated followed by insulin therapy. Ultimately, it is necessary to treat the complications of the other medical problems that develop. It is an insidious progressive disease that shortens the length and diminishes the quality of many peoples lives.
In bariatric surgery over the last few decades we’ve noticed a higher ratio of remission of type II diabetes associated with the Roux-en-Y gastric bypass in particular. Over the last several years the science has caught up with our observations. We now know that the gastric bypass stimulates the production of substances in the blood which leads to a reversal of the insulin resistance and better use of the insulin produced in the body. This is huge!
Several studies have now been done on patients with diabetes and obesity. The remission rate for type II diabetes in this patient population is as high as 80%. Those patients that do not respond tend to be those with a long history of 8-10 years of diabetes, or those who are already on insulin. We refer to it as a “remission” of diabetes as some patients down the road who experience weight regain will reactivate it and will need to restart medication therapy.
The take home message is: if you are a type II diabetic with a body mass index (BMI) over 30, you should have a conversation with your primary care physician, endocrinologist, or cardiologist about the potential of gastric bypass for remission of your type II diabetes. As always, you are welcome to call our office at 303-861-4505 with questions or visit us on Facebook.
Dr. Tom Brown
Colorado Bariatric Surgery Institute