Can bariatric surgery improve blood glucose control in Type 2 diabetes?

Type 2 diabetes is a chronic metabolic disorder marked by high blood sugar levels often resulting from a combination of insulin resistance and inadequate insulin production One emerging treatment option for patients struggling with blood glucose control is bariatric surgery also known as metabolic or diabetes surgery These procedures traditionally aimed at weight loss have shown significant potential in improving blood glucose control and even achieving longterm remission of diabetesThe link between Type 2 diabetes and obesityObesity is a major risk factor for type 2 diabetes Excess weight particularly visceral fat contributes to insulin resistance a hallmark of type 2 diabetes Many patients with type 2 diabetes find it difficult to manage their condition with lifestyle changes medication and insulin injections This is where bariatric surgery steps in as a powerful alternative By reducing the size of the stomach or altering the digestive tract bariatric surgery can significantly affect the hormones involved in glucose regulation leading to improved blood sugar controlTypes of bariatric surgery for diabetesSeveral types of bariatric surgeries have been shown to improve blood glucose control including gastric bypass and sleeve gastrectomy These surgeries work by altering the digestive system to promote weight loss and more importantly for diabetic patients by affecting the secretion of hormones like GLP1 glucagonlike peptide1 which plays a crucial role in regulating blood sugarGastric bypass surgery This procedure involves creating a small pouch at the top of the stomach and connecting it directly to the small intestine bypassing most of the stomach and the first part of the small intestine By limiting food intake and nutrient absorption gastric bypass not only results in significant weight loss but also triggers early and increased secretion of GLP1 promoting better blood sugar controlSleeve gastrectomy In this procedure a large portion of the stomach is removed leaving a bananashaped sleeve Like gastric bypass it restricts food intake and influences the production of hormones that regulate glucose metabolism Studies have shown that patients who undergo sleeve gastrectomy experience significant improvements in their blood sugar levelsHow bariatric surgery impacts blood glucose controlOne of the most striking benefits of bariatric surgery for diabetic patients is the rapid improvement in blood glucose control postsurgery Many patients can reduce or even eliminate their need for diabetes medications within days or weeks following surgery This improvement is not solely due to weight loss changes in gut hormone levels after surgery play a critical role Hormones like GLP1 and PYY peptide YY are secreted more efficiently which enhances insulin sensitivity and stimulates insulin production leading to better glucose regulationA key outcome of bariatric surgery is the possibility of longterm remission of diabetes Studies have shown that over 8037 of patients achieve glycemic resolution normal blood sugar levels and can discontinue diabetes medications within 1218 months postsurgery Even more promising 3637 of patients remain off diabetes medications ten years after the surgery indicating that bariatric surgery can have lasting effects on blood glucose controlCandidate selection for bariatric surgeryNot all patients with type 2 diabetes are candidates for bariatric surgery According to guidelines suitable candidates are typically adults over the age of 18 who have a body mass index BMI greater than 275 and have not been able to achieve adequate blood glucose control with lifestyle modifications and medications Other factors that are taken into consideration include the patientrsquos pancreatic function the presence of comorbidities and their suitability for anesthesiaEach patient is evaluated individually by a team of healthcare professionals including a bariatric surgeon endocrinologist and dietitian to determine whether bariatric surgery is an appropriate treatment optionRisks and considerationsAs with any surgery there are risks associated with bariatric surgery including infection blood clots and complications related to anesthesia In addition some patients may experience nutritional deficiencies such as vitamin B12 iron and calcium because of the reduced absorption of nutrients postsurgery Longterm followup and adherence to a postsurgical diet and supplement regimen are essential for minimizing these risksIt is also important to note that while bariatric surgery can lead to significant improvements in blood glucose control it is not a cure for type 2 diabetes Patients must continue to monitor their blood sugar levels maintain a healthy diet and engage in regular physical activity to sustain the benefits of the surgeryAlso ReadHeres how deepfried baked grilled foods are driving diabetes in IndiaConclusionBariatric surgery offers a powerful tool for improving blood glucose control in patients with type 2 diabetes especially those struggling to manage their condition through conventional means The surgerys ability to trigger changes in gut hormones leading to better insulin sensitivity and glucose regulation provides hope for longterm remission of the disease However it is important for patients to undergo a thorough evaluation and to be fully aware of the risks and lifestyle changes required postsurgery With careful consideration and management bariatric surgery can be a lifechanging option for those with type 2 diabetes providing not only improved blood sugar control but also a better quality of lifeDr Ramen Goel is Consultant Bariatricamp Metabolic Surgeon Wockhardt Hospitals Mumbai CentralThe views expressed here are the individualrsquos and donrsquot represent those of the paper