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Bariatric Surgery Helps Resolve Diabetes
What Is Diabetes?
Diabetes mellitus is a chronic metabolic condition in which the body has difficulty handling carbohydrates. This manifests as elevated blood glucose levels especially after meals. Acute effects may include frequent urination, thirst, lethargy, confusion and even a coma. Long-term effects involve multiple organ systems and may include cardiovascular disease, kidney disease, nerve disorders, and visual disorders, among others. Each of these long-term complications has significant morbidity associated, for example, risk of heart attacks, risk of amputations, risk of kidney failure requiring dialysis, and risk of intractable neuropathy.
How Is Diabetes Diagnosed?
Diabetes is diagnosed by blood tests that evaluate the body's glucose levels. This is usually done fasting or after a glucose challenge. Assessment of HBA1c (glycosylated hemoglobin) evaluates glucose control over a 2-3 month period.
Treatment for diabetes has centered around a carbohydrate restricted diet, regular exercise, behavior modification and medical therapies. Medical therapies include various oral medications, insulin injectable formulations, and newer non-insulin injectable drugs. These treatments are life-long in an effort to maintain normal blood glucose levels.
Role of Bariatric Surgery for Treatment of Diabetes
For morbidly obese individuals, weight loss has been shown to improve blood glucose control significantly. Weight loss helps to improve glucose metabolism and decrease resistance to the body's natural insulin. Studies have shown that both medical and surgical weight loss have produced significant results in the improvement and elimination of diabetes.
Surgical weight loss procedures such as gastric bypass and sleeve gastrectomy have been shown to produce effective and sustainable weight loss which results in resolution of diabetes for many patients undergoing bariatric surgery (weight loss surgery). Many patients have their glucose control improve immediately after surgery with medication requirement eliminated or significantly reduced. Long-term studies are showing this effect with HBA1c getting back within normal ranges for many affected patients. The effects of bariatric surgery are most pronounced when associated with lifestyle changes including healthy diets, regular exercise and behavioral changes that continue to promote weight loss.