Bariatric Surgery and Diabetes

Bariatric surgery can reverse Diabetes, but The Endocrine Society recommends people take caution before taking extreme actions.

 

Two points I found interesting include:

Remission in diabetes may be a result of the hormonal changes in the intestines after bariatric surgery.

“Observational studies have suggested that weight loss surgery can rapidly improve glycemic control and even produce remission of diabetes in severely obese patients with type 2 diabetes. This improvement and/or remission of diabetes is noted before meaningful weight loss occurs, and is thought to be due to a weight-loss independent change in the incretin hormone milieu as a result of the alteration in intestinal anatomy.  Complete remission is defined as a fasting glucose level below 101 mg per deciliter and a glycated hemoglobin level of less than 6.0% for at least 1 year without active pharmacologic therapy. Until now, however, there has been a paucity of randomized controlled trials showing greater efficacy for surgical versus medical therapy, and for the variety of weight loss procedures available.”

 

Bariatric surgery should involve decision making regarding the ability to make long term lifestyle changes and be supported by a multidisciplinary team.

“The Endocrine Society recommends that practitioners consider several factors in recommending surgery for their obese patients with type 2 diabetes. These include the patient’s BMI and age, the number of years of diabetes, and an assessment of the ability to comply with the long-term lifestyle changes that are required to maximize success of surgery and minimize complications. Importantly, shared decision-making is critical in making a decision about bariatric surgery. The success of weight loss surgery in patients with obesity and diabetes ultimately depends on the partnership of patient, endocrinologist, surgeon, and a support team in the continuum of the long-term care of the patient.”

 

Read the article at http://www.endo-society.org/advocacy/policy/upload/Bariatric-Surgery-and-Diabetes.pdf.

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