A procedure is considered Metabolic surgery when the benefits of the procedure include significant improvements in the patients metabolic health conditions. Some of the metabolic health conditions include Type 2 diabetes, High cholesterol and Metabolic syndrome.
About 30 million Americans currently are have Type 2 diabetes and another 80 million are pre diabetic. Despite medical advances in treating Type 2 Diabetes and newer and more effective medications diabetes is responsible for significant morbidity and mortality.
Bariatric surgery is the most effective treatment available to date to treat Type 2 diabetes when it is associated with obesity. Bariatric surgery had been shown to resolve Diabetes between 60-98% of treated patients depending in several factors including factors related to duration and severity of the disease as well as type of bariatric surgery.
Gastric bypass and Duodenal Switch had been shown to be most effective for Type 2 diabetes with 87-98% resolution maintaining normal sugars and A1c without medication usage. In several instances when Type 1 Diabetes patient has obesity, bariatric surgery though does not resolve type 1 diabetes will lead to a much better control with reduced insulin requirements. Gastric sleeve though less effective than the other two procedures still has excellent results with type 2 diabetes and is an effective alternative for patients that do not want gastric bypass or duodenal switch.
In certain patients though the obesity itself may not meet the NIH criteria for bariatric surgery the patient might benefit from bariatric surgery to help lose weight and also improve type 2 diabetes significantly. Even though the exact mechanisms are not yet identified it is believed that with these procedures the internal hormonal milieu is altered in a positive manner such that the pancreatic islets seems to be less inhibited and existing Beta cells improve function and may even increase in number.
Considering bariatric surgery for patients with type 2 diabetes and mild to moderate obesity is an involved decision. This typically happens in consultation with treating endocrinologists and bariatric surgeon along with patients family. Insurance does not cover these interventions at this time. To learn more about the options or schedule a consultation with Dr. Ganta please contact us at 512-257-2425.