Bariatric Surgery and Type 2 Diabetes

Finding out you have type 2 diabetes may prompt you to explore weight loss surgery since it’s clear that your weight is affecting your health.

What is type 2 diabetes?

Type 2 diabetes is a chronic disease that affects over a million Australians. It’s a progressive condition, meaning it gets worse over time.

When you eat carbohydrates, your body breaks the food down into simple sugars, mainly glucose, which are released into your bloodstream. Your body makes a hormone called insulin which acts like a key to unlock your cells and allow the glucose to enter and provide them with energy.

In type 2 diabetes, your body becomes resistant to insulin and the glucose gets stuck in your bloodstream. Your pancreas responds to your rising blood sugar level by pumping out more and more insulin in an attempt to get back to a normal blood sugar. But it’s not enough. The insulin doesn’t effectively control your blood sugar anymore. Your blood sugar keeps rising and your pancreas keeps trying harder. After years of this, your pancreas is simply worn out. By the time you’re diagnosed with type 2 diabetes, you may have lost 50-70% of your insulin-producing cells.

So, what causes insulin resistance and type 2 diabetes? Your risk is influenced by your:

• Genetics and family history
• Age
• Medical history of other conditions such as polycystic ovary syndrome, Cushing’s disease and previous gestational diabetes
• Lifestyle – a poor diet, sedentary lifestyle and being overweight all contribute to type 2 diabetes.

Diabetes is a serious condition, with long-term health consequences. It affects every part of your body and increases your risk of heart disease, stroke, vision loss, kidney damage and nerve problems.

It’s usually treated with lifestyle modifications and medications initially but, as it is a progressive condition, many people ultimately need insulin injections.

How does weight influence type 2 diabetes?

Obesity accounts for 80-85% of type 2 diabetes risk. Obese people are 80 times more likely to develop type 2 diabetes than lean people. Obesity, particularly excess fat around your abdomen, triggers changes in your metabolism that cause insulin resistance.

Losing weight can significantly improve your insulin sensitivity. Indeed, people can successfully manage type 2 diabetes by losing weight, eating well and exercising regularly (exercise also improves your insulin sensitivity).

Achieving lasting weight loss can be very difficult, though. That’s why bariatric surgery is so helpful for people with type 2 diabetes.

Type 2 diabetes and weight loss surgery

Bariatric surgery offers hope to people with type 2 diabetes who need to reduce weight. It’s shown significant results in the management of type 2 diabetes.

A 2019 study examined the results of gastric bypass surgery on patients with type 2 diabetes. They found that gastric bypass surgery causes type 2 diabetes to go into remission in over 70% of patients within 1 year of surgery.

That made a big difference to their health when compared with a control group of similar patients who did not have weight loss surgery. Five years after surgery, the gastric bypass patients had significantly reduced their risk of diabetes complications like eye disease and kidney disease.

A few years earlier in 2016, the CROSSROADS trial compared intensive lifestyle modifications with gastric bypass surgery to see which was more effective in reversing type 2 diabetes.

The lifestyle change group did the hard yards over the next year – doing at least 45 minutes of aerobic exercise 5 days a week, following a careful diet, and treating their diabetes optimally. A year later, 5.9% of them were in diabetes remission. What happened to those patients who had gastric bypass surgery? A year after their op, 60% of them were in remission.

Lifestyle changes with bariatric surgery

Bariatric surgery certainly helps to kickstart your weight loss, reducing the calories you consume and (depending on the type of operation) changing how your body absorbs food.

But you can’t continue living as you were before. Bariatric surgery is done in conjunction with lifestyle changes like following a healthy, nutritious diet and developing the habit of regular exercise.

That becomes much easier when you have the right support around you. Bariatric surgery shouldn’t just involve a surgeon but also a multidisciplinary team of other healthcare professionals who can give you the support you need to change your diet and increase your exercise in order to keep the weight off for good.

How can Dr Lockie help?

If you’re obese and living with type 2 diabetes, then the best thing you can possibly do for your health is to lose weight.

Dr Lockie provides many different types of weight loss surgery to help people with diabetes to reach a healthy weight. At your first consultation, we’ll talk through your situation and the risks and benefits of surgery. As one of Dr Lockie’s patients, you’ll also benefit from the skills of a dietitian, psychologist and exercise physiologists and receive continuing education through our patient support groups with Dr Lockie.

If you’d like to learn more about bariatric surgery for type 2 diabetes, please book in for your free consultation.

Disclaimer

All information is general in nature. Patients should consider their own personal circumstances and seek a second opinion. Any surgical or invasive procedure carries risks.