Bariatric Surgery Can Help Patients with Diabetes

December 2, 2024 | By Munyaradzi Chimukangara, MD, FACS; Jonathan Gipson, MD, FACS; Sarah Lippert, MD, FACS

November was American Diabetes Month, a time to focus on this growing epidemic. According to the American Diabetes Association, more than 38 million people in the United States have diabetes, with more than 1 million new cases diagnosed each year. Reports are shedding light on the value of weight-loss (bariatric) surgery for individuals with type 2 diabetes.

According to a May 15, 2021, article in Lancet, patients with type 2 diabetes added 9.3 years to their median life expectancy with bariatric surgery. This compares to 5.1 additional median life expectancy years for patients with no diabetes.

The gastrointestinal tract is a meaningful target for the treatment of type 2 diabetes because of its role in metabolic regulation. The National Institutes of Health wrote, “According to recently released guidelines, bariatric surgery should be recommended in diabetic patients with class III obesity (BMI 40+) regardless of their level of glycemic control, and patients with class II obesity (BMI 35-39) with inadequately controlled type 2 diabetes despite lifestyle and optimal medical therapy. Surgery should also be considered in patients with class I obesity (BMI 30-34) and inadequately controlled hyperglycemia despite optimal medical treatment.”

We offer two types of primary bariatric surgeries at North Memorial Medical Center:

• With gastric sleeve surgery, a portion of your stomach is removed, creating a smaller, narrower stomach called a “sleeve.” After surgery, the stomach resembles a banana. Food will still be absorbed normally in your intestines. Weight loss occurs fairly rapidly. The surgery works by restricting how much food may be eaten as the stomach is smaller, and by resetting hormones of the gut, which decrease hunger sensations and enable the body to use energy better to regulate metabolism.
• With Roux en Y gastric bypass, your stomach is divided to create a small pouch about the size of a large egg. Your intestine is divided and reattached to your new stomach pouch so that the stomach pouch empties into the small intestine, causing food to bypass the large portion of the divided stomach and approximately 120 – 150 cm of your intestine. This surgery works by restricting how much food may be eaten, as the stomach pouch that receives food when eating is small, reducing the absorption of calories by bypassing part of the intestine, as well as resetting some hormones of the gut to enable the body to use energy better to regulate metabolism.

Benefits of bariatric surgery extend beyond diabetes treatment and include treatment of high blood pressure, sleep apnea, high cholesterol, heart disease, infertility, polycystic ovary syndrome, joint pains, reflux disease, and fatty liver disease. It also can decrease the incidence of a number of cancers. If you have been diagnosed with type 2 diabetes and are considering bariatric surgery, or would like to learn more about this treatment, give us a call at 763-780-6699.