Diabetes and weight loss surgery: is bariatric surgery a cure for diabetes?

Diabetes and weight loss surgery

Weight loss surgery is very effective in provoking rapid weight loss and improving health. Usually, it is the bad health that makes people consider the surgery, especially in morbidly obese people. One of the burdensome conditions caused by excessive weight is diabetes. Diabetes and weight loss surgery are often correlated – there have been numerous studies analysing the relation of bariatric surgery and diabetes and the way they influence one another. Generally, it is agreed that bariatric surgery for type 2 diabetes is the most effective cure.

We will elaborate on the most important aspects and the relation of diabetes and bariatric surgery below. 

Weight loss surgery options

Weight loss surgery options include:

• gastric band
• gastric bypass
• gastric sleeve
• gastric balloon.

There are different options for weight loss surgery. After a personal consultation, the doctor chooses the bet option for the patient

There are also other types of weight loss surgery, e.g. duodenal switch, but the procedures listed above are the most frequent and effective ones. If you wonder which is the best weight loss surgery or you are determined to have balloon weight loss surgery, you need to know that bariatric surgery is not performed at request, but is a complicated life-saving surgery which needs a thorough examination. In other words, it is a bariatric surgeon who chooses which type of weight loss surgery is the best for an individual, and only when patients are qualified for several surgeries, they may choose one from different types of weight loss surgery suitable for them. Sometimes, you may find alternative gastric weight loss surgery options e.g. POSE, but usually, they are experimental, so their effectiveness hasn’t been proven yet. 

Regardless of the surgery type, the main assumption of bariatric surgery is to reduce the size of the stomach so that daily food intake is reduced to a minimum.

The benefits of weight loss surgery include:

• significant weight loss that can be achieved in a short time
• remission of type 2 diabetes
• decreasing the risk of heart disease
• improving mental health (solving problems connected with self-acceptance, social, family and work life)
• eliminating sleep apnea
• bringing relief to joints
• fertility improvement
• improving a general health condition and quality of life.

What is diabetes?

Diabetes is a condition where there is too much glucose in the blood, which causes serious health problems

We often hear about diabetes, but what is diabetes definition? Or is diabetes a disease? Diabetes mellitus is a name for a group of diseases which affect the blood sugar (glucose). Glucose is the main source of energy for cells, tissues, muscles, and the brain. It is the hormone called insulin that transports glucose from the blood and with diabetes, the body is unable to produce enough insulin to transport it or produce enough insulin but cannot make use of it for some reason. So, diabetes is a condition where there is too much glucose in the blood, which causes serious health problems. Well, knowing what is diabetes definition, let’s see what is diabetes type division:

• type 1 diabetes (it is an autoimmune disease)
• type 2 diabetes (it is an acquired disease)
• prediabetes (it a worrying condition that may evolve to type 2 diabetes)
• gestational diabetes (it is a condition that may happen to pregnant women).

The worrying information is that in 2019, over 450 million people across the world suffered from diabetes, and type 2 diabetes made up 90% of all cases. Diabetes is rated 7th death cause in the world. What is important, the great danger that comes from type 2 diabetes which is acquired and can be treated. 

What causes diabetes

The causes of diabetes vary depending on the diabetes type.

Let’s see what is diabetes caused by:

• Type 1 diabetes: it is an autoimmune disease and its precise causes are not known. However, the pancreas which produces insulin is for some reason attacked by the immune system. When insulin cells are destroyed, the glucose cannot be transported and it’s level in blood increases. There are reliable theories saying that it is a genetic condition or that there is a virus that attacks the immune system.
• Type 2 diabetes: this condition is caused by two factors – genetics and lifestyle. The genes shared by relatives may be partially responsible for the disease, so if you know that someone in your family suffers from it, you need to be particularly cautious. The second factor is a lifestyle, especially excessive weight. It is proven that type 2 diabetes develop in overweight and obese people who have fat accumulated particularly in the stomach area. This diabetes makes cells very resistant to insulin.
• Gestational diabetes: it’s cause is a hormonal change triggered by pregnancy. The most endangered group here are women who are overweight or obese once they get pregnant or gain too much weight during pregnancy.

Diabetes symptoms

Generally, the early signs of diabetes are hardly noticeable, and only when they become more troublesome over time, they can be diagnosed. People usually are able to live normally with diabetes symptoms, so it is very important to realize what are the symptoms of diabetes to be able to react relatively quickly.

The symptoms diabetes include:

• excessive thirst and urination (the glucose is stuck in the blood, so kidneys must work all the time to absorb and filter the glucose – once there is too much glucose, it is excreted to the urine; excreting glucose dehydrate us causing deep thirst)
• blurred vision (diabetes may affect the retina – at the beginning it isn’t noticed, but when untreated diabetes progresses, it may even cause blindness)
• increased hunger
• fatigue (the high level of glucose disturbs the body’s ability to use it for energy)
• swollen and red gums
• rapid weight loss (it belongs to frequent symptoms of diabetes type 1)
• hands or feet numbness
• sores and infections which heal very slowly.

Diabetes diagnosed at an early stage may be controlled and cause no harm to the organism

Once you notice any sign of diabetes, you should consult the doctor and check whether it may be diabetes. Diagnosed at an early stage, it may be controlled and cause no harm to the organism.

Diabetes type 2

What is diabetes type 2? It is a chronic disease which affects glucose metabolism. The body is unable to produce enough insulin to regulate the level of glucose in the blood or is resistant to insulin, which disturbs the glucose movement. Generally, these are adults who suffer from type 2 diabetes, but more and more children also become prone to develop this condition (due to prevalent obesity and lack of physical activity). Diabetes type 2 cannot be cured, but it can be controlled. The most effective way of minimizing the signs of type 2 diabetes is weight loss, a balanced diet, and exercising.

The risk factors that may lead to type 2 diabetes are:

• overweight and obesity
• sedentary lifestyle
• distribution of fat in the belly area
• genes and family history
• gestational diabetes
• prediabetes
• age (with age, the risk of diabetes increases)
• polycystic ovarian syndrome.

Type 2 diabetes may cause serious health problems, e.g. heart disease, nerve damage, eye damage, kidney problems, skin conditions, sleep apnea, hearing impairment, or Alzheimer’s disease. What may help prevent these complications is a healthy lifestyle including a balanced diet, exercising, losing weight, and supplements. Once the condition (it concerns also type one diabetes) is advanced, there are medications that manage diabetes.

Diabetes type 1

Type 1 diabetes develops mainly in children, however, there are also cases of adults developing diabetes type 1

What is diabetes type 1? It is known as insulin-dependent or juvenile diabetes – it is a chronic condition where the pancreas does not produce insulin at all or produce very little insulin, as a result of which glucose cannot be transported to cells and used for energy. Type 1 diabetes develops mainly to children, however, there are also cases of adults developing diabetes type 1. Similarly to type 2 diabetes, it cannot be cured, but can be managed and controlled once identified quickly – a healthy diet and physical activity are the most important here. Type 1 diabetes symptoms are the same as in type 2 diabetes. But regarding the causes, it is complicated because type 1 diabetes is an autoimmune disease – the body somehow destroys the cells producing insulin in the pancreas. It is agreed that the main cause is genetics and environmental factors (e.g. viruses).

The risk factors that may lead to type 1 diabetes include:

• genetics 
• family history
• age (the peaks of diabetes type 1 is in age 4-7 and 10-14)
• geography (the further from the equator, the higher rate of type 1 diabetes).

The health problems caused by type 1 diabetes include blood vessel disease, heart disorders, nerve and kidney damage, vision problems, feet problems, mouth and skin conditions and complications during pregnancy.

Difference between type 1 and type 2 diabetes

There is much similarity and difference between type 1 and type 2 diabetes. See the most important aspects of type 1 vs type 2 diabetes below.

Health problems caused by diabetes

Type 1 diabetes health problems and type 2 diabetes health problems are pretty the same.

The most common diabetes problems include:

• increased risk of heart disease
• pancreas malfunction
• kidney diabetes problems
• excessive urination, much protein in the urine
• constant thirst and hunger
• visual problems, blindness, cataract and glaucoma
• loss of consciousness
• increased risk of a stroke
• sweet-smelling breath
• high blood pressure
• increased risk of infections
• weakness and fatigue
• gastroparesis
• ketoacidosis
• damage in blood vessels and nerves
• problems with feet and hands, e.g. numbness
• cracked and dry skin.

Diabetes health problems may become really serious, even fatal, so it is really important that we regularly check the blood sugar level. Having diabetes under control prevents long term diabetes problems and enables normal living.

Diabetes treatment

Diabetes treatment is essential for maintaining good health. Of course, knowing how to prevent diabetes (type 2 diabetes) allows for avoiding the disease, but once it is developed, it must be controlled. Diabetes cannot be cured, but treatment for diabetes is really effective and minimizes the harm. Regarding type 1 diabetes, the most effective treatment of diabetes is insulin injection and insulin pump, regular checkups of blood sugar, and carbohydrate counting. As for type 2 diabetes, it is treated thanks to a change of lifestyle, controlling a blood sugar level, and diabetes medication.

1. Controlling blood sugar – it is a very important tool for monitoring diabetes. Usually, patients need to check blood sugar a few times a day before and after meals. If you take insulin, you need to check blood sugar very often, but if you don’t, the checkups are less frequent. Apart from daily tests done at home, patients are asked to do A1C testing regularly – it measures the level of sugar in the blood in the last 2-3 months.
2. Insulin – it is particularly important for type 1 diabetes patients. In fact, insulin allows them to live. There are several types of insulin, e.g. rapid-acting insulin, short-acting insulin, or long-lasting insulin. The specific types must be applied at regular intervals. Insulin cannot be taken orally because the enzymes in the stomach would disturb it’s working, so it is usually applied as an injection, with an insulin pen or with an insulin pump. The latest diabetes treatment involves an artificial pancreas which produce insulin – there are successful operations so far.
3. Medications – they may have oral or injection forms. Some medications work in a way that they stimulate the pancreas to insulin production and release, some reduce the production of glucose in the liver, and some make the tissues more sensitive to insulin. The medications that are the most frequent and really effective are Metformin and SGLT2.
4. Transplantation – it is a solution only for type 1 diabetes. Replacing the pancreas eliminates diabetes at all because the transplanted pancreas are able to produce needed amounts of insulin. However, sometimes the transplantation is rejected.
5. Weight loss surgery – it is proven that bariatric surgery can prevent diabetes problems caused by type 2 diabetes. The significant weight loss triggered by the surgery minimizes this disorder and regulates blood sugar level. Bariatric surgery as type 2 diabetes treatment NHS is possible when BMI exceeds 35, also the insurance may cover the cost of such a surgery.

Diabetes- diet and weight loss

When diabetes type 2 is diagnosed the diet is crucial for the patient’s health

Diet for diabetes (especially type 2 diabetes diet) is always the first step after diagnosing this condition. Firstly, such a diet allows for losing weight, and secondly, it eliminates all unnecessary sugars which are a source of all insulin problems. Usually, diabetics are advised to visit a dietician who can create the best diet for diabetes and weight loss. The main assumption of such a diet in regulating the level of sugar in the blood and triggering weight loss (for overweight and obese people). Type 1 diabetes and weight loss is not as important as type 2 diabetes and weight loss where it is mainly the excess weight that makes us insulin resistant. Weight loss diabetes diet created by a professional triggers a gradual and healthy weight loss and provides all necessary nutrients. 

So, what should be the diet for diabetes patients? It includes 3 main meals that are eaten regularly every day. The typical diet for diabetes should be rich in fiber-rich products, healthy carbohydrates, and good fats. 

The balanced diet for diabetes patient should include a variety of food from the following groups:

• vegetables: e.g. broccoli, greens, tomatoes, pepper, carrots, pea, corn, potatoes
• fruits: e.g. melon, oranges, apples, bananas, berries, grapes
• grains (whole grains): e.g. rice, wheat, barley, quinoa, oats
• proteins: e.g. fish, eggs, lean meat, chicken, turkey, nuts
• dairy products (low fat): e.g. yogurt, milk, cheese
• healthy fats: seeds, nuts, olive oil, avocado.

All fast foods, sweets, and snacks should be totally eliminated

What causes diabetes and weight loss difficulty? All fast foods, sweets, and snacks should be totally eliminated. Diabetics must also avoid fried meals, products with trans fat or saturated fat, food rich in sodium, and all beverages containing sugar (including alcohol).

A good diet for diabetes patients can work excellent only when combined with physical activity. You should find such an activity that you like and are able to do, e.g. yoga, swimming, walking, cycling, aerobics, squash. It doesn’t matter what you do, you just need to stay active as much as possible in your everyday life. Regular exercising helps lose weight faster and is beneficial for health. The problem arises when people cannot lose weight by diet and exercise, they are heavily overweight or obese and struggle with diabetes. Here, bariatric surgery is the only effective way of losing weight and improving health.

How bariatric surgery can help?

Bariatric surgery for diabetes treatment has been approved as the most effective type 2 diabetes solution. But is it the future of diabetes treatment? We don’t know that, but there is no other alternative now for obese people with diabetes. Weight loss surgery diabetes causes its remission due to a rapid and massive weight loss. The research analyzing bariatric surgery diabetes type 2 shows that the level of blood sugar drops rapidly after the surgery even if patients have not lost much weight yet. 

The idea of weight loss surgery is reducing the stomach capacity and changing the functioning of the digestive system.

The bariatric surgery diabetes remission is possible thanks to following factors:

• people eat much less and feel full very quickly
• the hormones in the gut are affected, which influences the production of insulin
• the production of bile acids is increased, which makes body much more sensitive to insulin
• the body can use insulin in a proper way, which lowers the level of sugar in the blood.

There are several types of bariatric surgeries, the most frequent of which are:

• gastric sleeve (gastric sleeve diabetes cure works in a way that it removes the big part of the stomach)
• gastric bypass (this bariatric surgery diabetes remission is caused by rerouting the digestive system so that it bypasses most of the stomach, also calories absorption is lower)
• gastric band (here, the band is put around the stomach and makes it smaller)
• gastric balloon (the silicone balloon is put in the stomach and inflated making much less space for food).

Weight loss surgery has been proven as the most effective type 2 diabetes solution

Bariatric surgery for diabetes (e.g. gastric sleeve diabetes resolution) is possible within the NHS when patients meet certain criteria, the main of which are having BMI over 35 and type 2 diabetes, attempting to lose weight through diet and exercising in the past and agreeing to permanent change of lifestyle.

The Endobarrier Procedure for Diabetes

If for some reason you want to avoid bariatric surgery, there is a solution for diabetes weight loss. More and more doctors use endobarrier to cure diabetes. The endobarrier is a plastic device having a shape of a thin sleeve – it lines the upper 60 centimeters of the small intestine, which makes that food is absorbed further in the intestine. Such delayed food processing in the digestive system enhances weight loss and reduces blood sugar levels. As for the procedure itself, it lasts about an hour and is performed under local anesthesia. The plastic sleeve is put through the mouth and the stomach to finally reach the small intestine. The whole idea of endobarrier is very similar to gastric bypass, but it is not as invasive as bypass, it can be reversed and is much more affordable than bariatric surgery.

Diet after weight loss surgery

Diet after weight loss surgery is very strict at the beginning, but later on, it boils down to healthy balanced meals. It is important that bariatric patients realize what such a diet looks like and know what to expect. Weight loss surgery post op diet may differ depending on the surgery type, but generally, it involves the following stages:

1. Clear liquids – week 1
2. Full liquids – week 2
3. Pureed food – week 3-4
4. Soft diet – week 4-8
5. Healthy, balanced diet – from month 3, lifelong.

Dietary guidelines after bariatric surgery are always explained by a bariatric surgeon and dietician. We also describe in detail the post weight loss surgery diet in another article.

Does weight loss surgery cure diabetes?

Diabetes cannot be cured, but it can be controlled and minimized. Bariatric surgery can help with that

The research in bariatric surgery diabetes proves that the surgery is highly effective in treating diabetes. There is no weight loss surgery diabetes cure, just because diabetes cannot be cured, however it can be controlled and minimized. Type 2 diabetes is usually developed when people are heavily overweight or obese – eating mostly fatty food and carbohydrates makes the body resistant to insulin, which increases the blood sugar level. The post bariatric surgery diabetes test results show that 60% of patients after weight loss surgery have no signs of diabetes at all, their cholesterol, blood sugar level, triglyceride level, and blood pressure improve significantly. To compare, medications show improvement in 6-8% of diabetics. So, we can say that bariatric surgery diabetes cure is the most effective solution to type 2 diabetes in the 21st century.

Best weight loss surgery for diabetes

Do you wonder what is the best weight loss surgery for diabetes? Well, each bariatric surgery is proved to be effective in treating type 2 diabetes. The only condition is that a patient follows a dietary regime and engages in physical activity. In fact, the best weight loss surgery for type 2 diabetes is a procedure that is the best for an individual. Some patients are advised to get a gastric sleeve or bypass and some gastric band or less invasive gastric balloon. It depends on an individual which surgery is recommended. Such factors as BMI, health condition, medical tests results, age, medical history, or any chronic diseases may qualify or disqualify a patient. So, it is always a bariatric surgeon who determines which weight loss surgery is best for diabetes and weight loss.

Summary

Diabetes is a very serious chronic disease which requires constant medical control. Untreated, it may have deteriorating effects on our health. Weight loss surgeries are extremely effective in treating type 2 diabetes, so if you are obese and suffer from diabetes, bariatric surgery may be the last resort. The rapid weight loss and hormone changes caused by the surgery cause diabetes remission which occurs really soon after the procedure. At present, there are no more effective treatments for type 2 diabetes than obesity surgery, so if you would like to overcome this condition, you should definitely talk to your doctor and consider bariatric surgery options.

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