What type of bariatric surgery is best for those with Type 2 diabetes?

Published: Tuesday, September 17, 2024
Bariatric Surgery

Type 2 diabetes can affect anyone of any age, sex, race and weight, but it’s more common among those who are overweight or obese. Bariatric surgery can offer a solution for lowering blood sugar and even reversing Type 2 diabetes.

The Centers for Disease Control and Prevention estimates that more than 38 million people in the United States have diabetes—and the vast majority of those people have Type 2 diabetes. Unlike Type 1 diabetes, which has a genetic component and occurs when the pancreas doesn’t produce insulin, Type 2 diabetes relates to how the body uses insulin.

Taking steps to practice healthy lifestyle habits, such as exercising regularly and eating a diet filled with fruits and vegetables and low in added sugar, can improve insulin sensitivity and lower a person’s blood sugar into a healthier range.

Losing weight can also lower blood sugar in those who have Type 2 diabetes. Keep reading to learn how—and how bariatric surgery can help.

How losing weight affects blood sugar

Type 2 diabetes occurs when the body doesn’t use insulin properly, which causes a buildup of blood sugar (glucose) in the body. This can occur due to a number of factors, but insulin resistance is a common one.

When the body is functioning normally, the pancreas produces insulin, a hormone that regulates blood sugar. The body relies on something called insulin sensitivity to cause cells in your muscles, fat and liver to respond to insulin by using it for energy or storing it.

Those who have Type 2 diabetes often have reduced insulin sensitivity, also called insulin resistance, which essentially causes the body to ignore insulin. When this happens, glucose builds up in the blood, leading to high blood sugar.

In addition to increasing blood sugar, reduced insulin sensitivity can cause higher triglyceride levels, plaque buildup in the arteries and high blood pressure. This can lead to heart disease, nonalcoholic fatty liver disease, metabolic syndrome and polycystic ovary syndrome.

Insulin resistance is often associated with being overweight or obese. Researchers believe that excess fat, particularly in the abdomen and around body organs, is the primary cause of insulin resistance. A lack of physical activity and a highly processed diet can also increase the risk of reduced insulin sensitivity—and Type 2 diabetes.

Losing weight, then, can have a significant impact on your health. If you’ve been diagnosed with Type 2 diabetes, losing even a small amount of weight can lower your blood sugar into a healthier range, reduce the need for medications, lower your risk of other health issues and even reverse Type 2 diabetes in some cases.

Talk with your primary care provider (PCP) about a strategy for losing weight. You may have success by exercising more and eating fewer processed foods or by using certain prescribed medications, including GLP-1 receptor agonists like Ozempic. In cases where diet and exercise aren’t enough, bariatric surgery offers hope.

Bariatric surgery for those with diabetes

Wondering if bariatric surgery is right for you? Your PCP can offer guidance about whether you’re a candidate for bariatric, or weight-loss, surgery.

Bariatric surgery may be recommended for:

  • Those who have a body mass index (BMI) of 40 or higher
  • Those who have a BMI of 35 or higher along with a serious health issue such as Type 2 diabetes or heart disease
  • Those who have a BMI of 30 or higher along with Type 2 diabetes that can’t be controlled with other treatment options

Why is Type 2 diabetes listed so prominently among the qualifications for bariatric surgery? High blood sugar can have a negative impact on nearly every aspect of a person’s health, damaging blood vessels, causing vision changes, impairing nerves throughout the body and increasing the risk of other health conditions.

If you’ve been diagnosed with Type 2 diabetes, it’s essential to find the right strategy for lowering your blood sugar into a healthy range. When that’s not possible with lifestyle changes or medications, bariatric surgery may be recommended.

In fact, bariatric surgery offers more benefits for those who have Type 2 diabetes than lifestyle changes alone. A study published earlier this year found that weight-loss surgery not only helps patients lose weight, but it also helps them manage diabetes, improve cholesterol and triglycerides and even achieve diabetes remission in many cases.

What type of bariatric surgery is best for those who have Type 2 diabetes? If you’re interested in pursuing bariatric surgery, specialists at the Bariatric Weight Loss Center can help you determine which procedure is best for your specific needs.

There are multiple types of weight-loss surgery, and each can benefit those with diabetes by promoting weight loss. The different procedures work in distinct ways:

  • Gastric bypass
    A gastric bypass changes the gastrointestinal tract, causing food to bypass most of the stomach and part of the small intestine. According to the American Society for Metabolic and Bariatric Surgery (ASMBS), this procedure, also called Roux-en-y gastric bypass, leads to remission of Type 2 diabetes in nearly 80 percent of patients due to weight loss and metabolic changes.
  • Vertical sleeve gastrectomy
    A vertical sleeve gastrectomy removes a portion of the stomach, leaving a smaller reservoir for food. This procedure also causes metabolic and hormonal changes, which can improve blood sugar. The ASMBS reports that those who undergo vertical sleeve gastrectomy experience remission in more than 60 percent of cases.
  • Duodenal switch
    A duodenal switch includes two different procedures performed as one. The first is similar to gastric bypass, while the second divides the small intestine in two tracts. Food moves through only one of those tracts, bypassing most of the small intestine. This reduces the amount of calories and nutrients absorbed by the body.

    While duodenal switch, also called biliopancreatic diversion with duodenal switch, is less common than other weight-loss procedures, recent research shows that it may be most effective in eliminating Type 2 diabetes.

The ASMBS reports that more than 85 percent of those undergoing duodenal switch experience Type 2 diabetes remission. A 2019 study confirms that—showing that the procedure is better at reducing diabetes because it both causes greater weight loss and the procedure itself improves insulin resistance.

The best bariatric surgery for treating Type 2 diabetes, however, may be different for you than it is for someone else. Bariatric specialists can help you determine which type of surgery will align with your needs and offer the most benefits for your health.


Next steps

The Bariatric Weight Loss Center at Northeast Georgia Medical Center offers comprehensive weight-loss services, including both surgical and nonsurgical treatment options. Call 770-525-6613 or watch our patient education video to learn more.