Type 2 Diabetes
Bariatric surgery has long been associated with improvements in type 2 diabetes control. At first this effect was thought to be down to the beneficial effect of post-op weight loss. However, recent studies have shown that surgery also directly affects how the body controls blood sugar by changing the levels of special hormones made by the intestine. These ‘gut hormones’
- affect how your body makes and uses insulin, leading to lower blood sugar levels
- increase the amount of bile acids that your body makes – these make your body cells more sensitive to insulin
The most effective operations that help type 2 diabetes (in order of effectiveness) are the one anastomosis gastric bypass; the Roux-en-Y gastric bypass and the sleeve gastrectomy.
Surgery for type 2 diabetes is not necessarily a permanent cure, but for the majority of patients it offers the chance to reduce or even completely stop diabetes drugs (including insulin and non-insulin injections).
New guidelines state that bariatric surgery should be recommended to you as a treatment for your diabetes if you have:
- a BMI over 40 (regardless of how well-controlled your diabetes is)
- a BMI 35-40 with poor diabetes control on medication
If you have a BMI between 30 and 35 with poor blood sugar control, surgery should be considered as an alternative treatment option.
If you are of Asian origin, these BMI cut-offs are all reduced by 2.5 BMI points (i.e. lowest recommended BMI 27.5).
These new diabetes guidelines were published in 2016. They are endorsed by 45 international professional organisations, including Diabetes UK. For further information about bariatric surgery as a treatment for type 2 diabetes please click here