Type 2 Diabetes
Metabolic Surgery Provides New Hope
for Individuals Suffering with Obesity and Type 2 Diabetes
Weight loss surgery is being dubbed as Metabolic surgery and refers to procedures that can help return the obese individual’s metabolism to that of a healthy one. For Type 2 Diabetes and Fatty Liver are only some of the manifestations of Obesity affecting the metabolism.
Weight loss surgery for type 2 diabetes is now globally recommended for patients with a body mass index of 30 or more, where high blood sugar is not controlled well, despite treatment with either oral or injectable diabetes medications. These new evidence-based guidelines for the surgical treatment of type 2 diabetes have emerged from an international diabetic conference. The guidelines and approach to diabetes have been “hailed as the biggest change to the treatment of the disease in almost a century”, a Sydney Morning Herald article reports. You can read the full report here: Metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by international diabetes organisations.
Mini Gastric Bypass (MGB):
One of the most powerful options for overweight diabetics
You may not have heard of the Mini Gastric Bypass (MGB) however this procedure has now received the endorsement of several surgical societies when it comes to not just weight loss, but also resolution of diabetes.
The MGB involves making a small stomach pouch and attaching it to a loop of small bowel, thereby bypassing the part of upper small bowel, as shown in the image.
Not only does the MGB provide the individuals with portion control of food but somehow bypassing part of the upper small bowel allows the body’s insulin sensitivity to improve – thereby requiring less insulin from outside. This causes the diabetes to improve.
The MGB also has the advantage of just one join (anastomosis) in comparison to the other type of bypass (Roux–en–Y) which involves two joins.
The resolution of diabetes depends on:
- How long have you had diabetes for
- Whether you have needed to start on insulin
- What type of surgery you’re considering
- The amount of weight lost
How could weight loss surgery for type 2 diabetes help?
When a patient undergoes metabolic surgery huge changes take place in the gastro-intestinal anatomy. These changes can lead to weight loss, and in some cases they can also improve the patient’s ability to process sugars. There are many theories as to why this happens. Some experts say that changes in gut hormones allow the patient to process glucose better. Others point to surgery leading to a more effective bile acid metabolism. Others say surgery can improve the rate of nutrient sensing and metabolism in the intestinal tract. New theories also point to an improvement in gut microbiota following surgery.
You can read more about this research here: Metabolic Surgery for Type 2 Diabetes: Changing the Landscape of Diabetes Care
What do these findings mean for type 2 diabetics?
These conclusions should mean improved clinical approaches to type 2 diabetes in Australia and internationally. Currently in Australia, some of the costs of procedures such as gastric sleeve, gastric bypass, Mini Gastric Bypass and lap band surgery are partially covered under Medicare for morbidly obese patients. These surgeries are also eligible for rebates under the Private Health System. We are hoping that this consensus on the effectiveness of metabolic surgery in diabetic patients will mean better access to metabolic surgery under our health care systems for type 2 diabetic patients in Australia who fit the recommended criteria.
Professor John Dixon, physician and diabetes researcher at Baker IDI Heart and Diabetes Institute agrees. “We’ve got to shake up our public hospital system in each state and remove the barriers that are preventing people for getting this treatment,” Professor Dixon told SMH.
Both diabetes, and obesity are diseases which have grown to epic proportions in our society. Physicians look to this research to provide the type of guidance which will ensure that all Australians are given better health outcomes going forward. Exactly why metabolic surgery is effective in treating diabetes type 2, and ultimately, why this disease occurs at all, are exciting and important questions researchers can begin to ask in this field.