Surgery for Treating Obesity and Diabetes

Surgery as treatment for Type 2 diabetes used to be reserved only for those who were extremely obese, because the procedures were originally designed to treat extreme obesity. Now, interest in using surgery for treating Type 2 diabetics who are either overweight or have mild obesity, is surging due to the epidemic of overweight, obesity, and Type 2 diabetes.

Results of the latest study, completed at University Hospital in Santiago, Chile, were published in September 2012 in the journal Obesity Surgery. Thirty-one people with Type 2 diabetes and a body mass indices (BMI) between 30 and 35 were treated with a procedure known as a laparoscopic Roux-en-Y gastric bypass.

After 36 months the average body mass index went down to 24.7 and all the diabetics showed an improvement in their blood sugar levels. Only one diabetic suffered from a complication, internal bleeding.

From these results, it was concluded the procedure is safe and effective for overweight or mildly obese Type 2 diabetics.

Laparoscopic refers to surgical procedures that take place with the use of a thin, lighted tube which is inserted into the abdomen... as opposed to the traditional method of making a large incision. The advantages of laparoscopic surgery include less scarring and a much quicker recovery time. It is less expensive than traditional surgery and generally has fewer complications.

Roux-en-Y gastric bypass consists of making a small pouch from the stomach and connecting it to part of the small intestine called the jejunum. When the stomach is connected to the jejunum, the upper portion of the small intestine, the duodenum, is bypassed...

• fewer calories are then absorbed when food does not go through the duodenum, and fullness is felt sooner in the smaller stomach.
• right after surgery, patients must eat a liquid diet and are gradually able to add small amounts of solid foods.

Because the duodenum is bypassed, there is a danger of osteoporosis because calcium is not absorbed as readily. People who have this surgery can also become deficient in magnesium, iron, vitamin B12 and other vitamins: meals must be planned accordingly.

Of course, anyone having this type of surgery must still control food portions because overly large portions can stretch the stomach pouch, making it able to hold more. High calorie snacks such as sugary soft drinks also need to be avoided.

Most people lose about half their excess weight and gain back 20 to 25 per cent of what they lost, in the following ten years. The most successful patients are those who maintain a sensible low-calorie diet and exercise regularly. The procedure is not a magic bullet, but can be a useful tool when used properly.