Gastric bypass seems like an easy solution for Type 2 diabetes. If the stomach is surgically reduced so it can contain only a tiny amount of food, then high blood sugar levels should be a thing of the past. It seems like such a good idea that many doctors are encouraging their patients to have gastric bypass surgery before they try other non-surgical treatments such as diet, exercise, and medication.
But does gastric bypass surgery really cure Type 2 diabetes?
Dr. Christine Ren, who identifies herself as an associate professor surgery at New York University, says it does. The owner of a website called Thin for Life, Dr. Ren reported measurements of her patients five years after lap-band surgery:
- the mean BMI was decreased from 46.3 to 35.0, that is, from morbidly obese to borderline morbidly obese.
- average fasting blood sugar levels decreased from 146 mg/dL to 118.5 mg/dL (8.1 mmol/L to 6.6 mmol/L). Both numbers are high enough, however, to be associated with an increased risk of diabetic retinopathy.
- average HbA1c decreased from 7.53% to 6.58%, but still high enough to cause risk of kidney failure.
The figures for Roux-en-Y bypass, which is essentially an irreversible form of stomach amputation, are even worse. The newsletter Endocrine Today reports that 80 per cent of Roux-en-Y bypass patients experience total remission from Type 2 diabetes, but that 72 per cent later become diabetic again.
The reason for this is simple. For about six weeks after this kind of gastric bypass surgery, all carbohydrates are forbidden. When carbohydrates are added back into the diet even a tiny amount causes high blood sugar levels.
What is Weight Loss Surgery?
Weight loss surgery basically reduces the capacity of the stomach to hold food. The two main types of weight loss surgery are:
- gastric bypass surgery… which re-routes food to the small intestine. The stomach is stapled to create a small pouch and a section of the small intestine is attached to the pouch so food then passes through very little of the small intestine
- restriction surgery… as the name implies restricts the amount of food in the stomach. Food is restricted by the placement of an adjustable lap-band around the stomach to reduce it’s size
When you have a surgical procedure as treatment for obesity, you must be willing to commit to:
- lifelong medical follow-up
- undertake a program of diet and exercise
- change your behavior towards food
- be determined to keep weight off
Various commentators claim up to 97% cure rates for Type 2 diabetes with gastric bypass surgery, but no such claim can be backed up with actual evidence. It’s easier, cheaper, and safer to use diet, exercise, and medication to get blood sugar levels back into control.