It has been over 10 years since the resolution of type 2 diabetes was observed as an additional outcome of surgical treatment of morbid obesity. However, it has been shown unequivocally that diabetes-related morbidity and mortality have declined significantly postoperatively, and this improvement in diabetes control is long lasting. Bypass procedures, the Roux-en-Y gastric bypass (RYGBP) and the biliopancreatic diversion (BPD), are more effective treatments for diabetes than other procedures and are followed by normalization of concentrations of plasma glucose, insulin, and HbA1c in 80–100% of morbidly obese patients.
Lifestyle intervention programs with diet therapy, behavior modification, exercise programs, and pharmacotherapy are widely used in various combinations to treat obesity. Unfortunately, with extremely rare exceptions, clinically significant weight loss is generally very modest and transient; particularly in patients with severe obesity.
There is a great interest in the mortality and morbidity associated with bariatric surgery in the medical community, in the media and, understandably, in the minds of morbidly obese patients. In part, this interest is due to the universal appreciation of the consequences of the global obesity epidemic, the growing recognition that bariatric surgery is currently the most effective therapy for the disease of morbid obesity. Yet, because there is still reluctance to accept obesity, and even morbid obesity, as a disease entity, the surgery for this problem and its operative mortality are not well accepted by the medical and lay communities.
How Does Gastric Bypass Surgery Cure Type 2 Diabetes?
Gastric bypass surgery often improves the symptoms of type 2 diabetes, even before patients start to lose weight.
Doctors are hopeful they can find a way to mimic the processes that lead to improvements for type 2 diabetics after gastric bypass without actually doing the surgery.
Small Intestine to the Rescue
How it works: After gastric bypass, which is a common weight loss solution for the severely obese, the small intestine spontaneously begins to produce a molecule called GLUT-1 that helps the body use glucose.
Although weight loss and improved diabetes symptoms go hand in hand, previous research has shown that gastric bypass surgery helps resolve the disease even before weight loss occurs.
The condition can lead to eye, kidney, and nerve damage, and puts patients at greater risk of heart attacks and stroke.