Could Bariatric Surgery End the Type 2 Diabetes Epidemic

Could Bariatric Surgery End the Type 2 Diabetes EpidemicBariatic surgery, or weight loss surgery as it’s more commonly called, can help people who’ve failed to lose weight despite trying every other option. But evidence is mounting that these procedures do more than just help obese patients drop extra pounds. For some people, weight loss surgery may also help bring about a remission of Type 2 diabetes.

Not every obese patient with Type 2 diabetes will experience remission of the disease after bariatric surgery. In those who’ve had diabetes for longer than about four years, the pancreatic cells that produce insulin — called beta cells — have mostly died off due to the progression of the disease. These cells are irreplaceable, and without them, Type 2 diabetes becomes incurable.

Doctors don’t fully understand why bariatric surgery causes diabetes remission in some patients, but they think that these procedures have a more profound effect on metabolism than once thought. Patients who get the procedure must also make drastic lifestyle changes that can also help bring blood sugar under control.

Bariatic Surgery Cures Type 2 Diabetes for Some

Researchers at the Cleveland Clinic studied the effects of three different types of diabetes treatment on a group of 150 people with Type 2 diabetes and a BMI of 37. One group of participants were treated with the usual medical treatment for Type 2 diabetes — insulin and lifestyle changes. A second group received gastric-bypass surgery, a type of bariatric surgery, in addition to treatment with insulin and lifestyle changes. The third group received sleeve gastrectomy, another type of bariatric surgery, along with standard diabetes treatment.

The researchers found that about one-third of the gastric bypass patients and one quarter of the sleeve gastrectomy patients had achieved diabetes remission. These patients remained in remission three years after the surgery.

Additional research shows that diabetes remission after bariatric surgery could last much longer than three years. One study that followed 400 people with Type 2 diabetes found that 62 percent of those who had bariatric surgery continued to show diabetes remission six years later. Thirty percent of people who achieve diabetes remission through weight loss surgery maintain that remission 15 years later. Just six to eight percent of people who used only medication and lifestyle changes to treat their diabetes experienced lasting remission.

Cost of Bariatric Surgery vs. Cost of Diabetes Management

dec23-2There are several types of bariatric surgery, some more complicated than others. Many are not reversible, but some are. Each procedure carries its own complications and each requires drastic changes in lifestyle in order to achieve results. Since many bariatric surgeries affect your body’s ability to absorb nutrients from food, it’s important to work with a nutritionist in making dietary changes post-surgery. The most effective bariatric surgery for treating diabetes is gastric bypass, in which a surgeon reduces the size of your stomach and re-routes your intestines so that food bypasses the small intestine.

Bariatric surgery is expensive. It costs between $11,500 and $26,500 and many insurance providers may not cover it, although coverage for the procedure has increased under the Affordable Care Act. But standard diabetes management isn’t cheap either. More than 29 million Americans currently suffer from the disease, costing a total of $245 billion in 2012.

An April 2014 report from Express Scripts called diabetes medication “the most expensive traditional therapy class when ranked by per-member-per-year.” For the individual diabetes sufferer, yearly medical costs can average $7,900 for diabetes treatment alone, and an additional $5,800 for treatment of complications and other medical concerns. It’s costs like these that have many Americans looking to save money on prescription drugs at

Doctors stress that weight loss surgery is a last-resort option and that it’s not a solution for obesity by itself — patients must work hard to change their eating and exercise habits. However, if weight loss surgery can successfully bring diabetes into remission for just two to three years, it can pay for itself. If remission lasts longer than three years, it can save the patient money on diabetes-related medical costs.

Nor is there any reason to believe that weight loss surgery is a permanent solution to Type 2 diabetes. The disease can still return years later, as research has shown. However, doctors say that if the procedure is successful, patients will be in a better position to manage diabetes should the condition return. Fewer dietary changes will need to be made, for example, and patients who have experienced significant weight loss find it much easier to exercise regularly. It’s also important to remember that those patients who have experienced Type 2 diabetes remission are those who were diagnosed less than four years ago.

If you’re considering weight loss surgery to help you shed the extra pounds that you’ve failed to lose through diet and exercise alone, there’s a chance that the procedure could also help you achi