Category Archives: Bariatric Surgery

Roll the Dice: Bariatric Surgery Prolongs Life in Type 2 Diabetes

bariatric surgery, Steve Parker MD

Band-type gastric bypass, a type of metabolic surgery

Bariatric surgeries are considered by some experts (mostly surgeons?) to be the most effective way to treat or cure type 2 diabetes. They are effective, assuming you survive the original operation and potential complications, which may require further surgery.

From JAMA Network:

Among patients with type 2 diabetes and obesity, metabolic surgery, compared with nonsurgical management, was associated with a significantly lower risk of incident [heart attack, ischemic stroke, and mortality]. The findings from this observational study must be confirmed in randomized clinical trials.

Source: Association of Metabolic Surgery With Major Adverse Cardiovascular Outcomes in Patients With Type 2 Diabetes and Obesity | Bariatric Surgery | JAMA | JAMA Network

Steve Parker, M.D.

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At Three Years, Gastric Bypass Superior to Intensive Medical Therapy for Obese Type 2 Diabetes

…in terms of weight loss, lowering of HgbA1c, and weight-related quality of life. The specific gastric bypass surgery used in the study is the Roux-en-Y version.

bariatric surgery, Steve Parker MD

Band Gastric Bypass Surgery (not the only type of gastric bypass): very successful at “curing” T2 diabetes if you survive the operation

Average initial weight of participants was 104 kg (229 lb). Bypass patients dropped their weight by 25 kg (55 lb)and HgbA1c decreased by 1.8% (absolute decrease), compared to intensive medical management participants who lost 10.3 kg (32 lb) and dropped HgbA1c only by 0.4%.

I doubt that intensive medical therapy included a low-carb Mediterranean or paleo diet.

Source: Clinical and Patient-Centered Outcomes in Obese Patients With Type 2 Diabetes 3 Years After Randomization to Roux-en-Y Gastric Bypass Surgery Versus Intensive Lifestyle Management: The SLIMM-T2D Study | Diabetes Care

 

Getting Bariatric Surgery to Improve Your Type 2 Diabetes? RYGB May Beat LAGB

An article at Diabetes Care suggests that insulin-treated T2 diabetics getting bariatric surgery were almost twice as likely to get off insulin if they had roux-en-Y gastric bypass rather than laparoscopic adjustable gastric banding. The former procedure is also generally more effective for weight loss.

If you think bariatric surgery is a sure-fire cure for type 2 diabetes, it’s not. I would go as far as I could with diet and exercise before going under the knife.

Steve Parker, M.D.