In 2006, diabetes was the seventh most common cause of death in the U. S., according to a June 2010 report of the American Society for Metabolic and Bariatric Surgeons. Of the nearly 24 million Americans who have diabetes, about 50 percent of the men and 70 percent of the women are obese. Weight loss surgery may provide a solution for obese diabetics.
Obesity and Health Risk
The body mass index or BMI, calculated using the individual's height and weight, compares actual weight to ideal weight. A BMI of 18.5 to 29.9 indicates normal weight; 25-29.9, overweight; 30-34.9, obese; 35-39.9, severely obese; and 40 and up, morbidly obese, according to the Surgical Specialists of Louisiana.
The level of health risk rises with the extent of obesity, from low risk for those of normal weight; high risk for obese individuals; and extremely high for morbidly obese individuals. Obesity-related conditions include type 2 diabetes, high blood pressure, cancer, stroke and heart disease. Mildly obese individuals have double the risk of developing diabetes. Moderately obese people have five times the risk of becoming diabetic and those in the severely obese category have ten times the risk, according to the American Society of Metabolic and Bariatric Surgeons.
Type 2 Diabetes
Diabetes mellitus, a chronic condition that affects the metabolism of sugar, occurs in two forms. Type 1 diabetics, comprising five to 10 percent of all diabetics, cannot produce insulin in the body and must inject insulin every day. The other 90 to 95 percent have type 2 diabetes, meaning that they do not produce enough insulin or their bodies are resistant to insulin.
Type 2 diabetics may manage their blood sugars with diet, exercise, weight loss and, in some cases, insulin or oral diabetes medications. Diabetics of either type have a higher risk of strokes, high blood pressure, dental disease, kidney disease, heart disease, amputations and nervous system disorders, according to the American Society for Metabolic and Bariatric Surgeons.
Weight Loss Surgery
Bariatric or weight loss surgery procedures help obese people lose weight and keep it off. Those eligible for surgery include individuals with body mass indexes of at least 40, as well as those with BMI's of 35 to 39.9 who have obesity-related diseases such as diabetes, according to the Surgical Specialists of Louisiana. Types of surgery include the gastric bypass, adjustable gastric band or Lap-Band; gastric sleeve, gastroplasty and biliopancreatic diversion with duodenal switch. The surgeon determines the type of procedure based on the patient's body mass index, general health and the amount of weight to be lost.
Results
An analysis 135,246 bariatric surgery patients in 621 studies between January 1990 and April 2006, demonstrated that bariatric surgery significantly improves or resolves type 2 diabetes, according to Henry Buchwald, M.D., Ph.D., lead author of the study published in the March 2009 issue of the "American Journal of Medicine." Among the 22.3 percent of type 2 diabetics in the studies, 80 percent experienced improvement or resolution of diabetes based on laboratory studies of their fasting glucose, insulin and HgA1c levels and 75 percent remained symptom-free more than two years later. Those undergoing biliopancreatic diversion/duodenal switch experienced the highest percentage of diabetes resolution -- 95.1 percent -- followed by 80.3 percent of the gastric bypass patients; 79.7 percent of gastroplasty patients; and 56.7 percent of gastric banding patients.
Considerations
Although bariatric surgery provides an effective weight loss tool, you may not qualify if your body mass index does not exceed 35 with diabetes or 40 without diabetes, according to the Surgical Specialists of Louisiana. Even if you qualify for surgery, you may prefer a non-surgical method for weight loss, including increasing exercise, eating more healthfully and taking medications, including insulin, according to MayoClinic.com. If you decide to have weight loss surgery to improve your diabetes, you must understand that long-term success depends on making permanent lifestyle and dietary changes to maintain weight loss.
References
- WhyWeight.com: About Obesity
- ASMBS: Rationale for the Surgical Treatment of Morbid Obesity
- ASMBS: New Study Confirms Long-Term Effectiveness of Gastric Banding on Type 2 Diabetes and Improvement
- ASMBS: Type 2 Diabetes: Prevalence, Surgery, Complications & Cost
- MayoClinic.com: Type 2 Diabetes
- ASMBS: Weight and Type 2 Diabetes Systematic Review and Meta-Analysis
