Can Bariatric surgery treat people with obesity & diabetes?

Can Bariatric surgery treat people with obesity & diabetes?

Diabetes is a chronic disease that can cause nerve damage among other long-term problems. One method of weight loss is bariatric surgery, which may be necessary for some obese people.

According to a recent study, bariatric surgery may benefit those who have type 2 diabetes by reducing peripheral neuropathy. To assist patients in maintaining a healthy body weight, doctors employ a range of strategies. Bariatric surgery may be advantageous for those who are obese.

To fully comprehend the advantages of bariatric surgery, researchers are still working. How bariatric surgery might affect particular diabetic problems is one topic of investigation.

An investigation of the effects of bariatric surgery on diabetic complications in obese patients was recently published in Diabetologia.

Researchers saw stabilisation of retinopathy and cardiac autonomic neuropathy as well as improved peripheral neuropathy.

long-term impact of diabetes

Diabetes is a persistent disease. It has to do with how well the body can use glucose (sugar) for energy and the hormone insulin.

Diabetes has a number of long-term problems that might develop if it is not well managed. For instance, peripheral neuropathy, which is nerve damage that affects the feet, legs, arms, and hands, is one problem.

Another is retinopathy, which eventually harms the eyes and impairs vision. The nerves that govern the heart are also damaged in cardiac autonomic neuropathy. These damage areas may result in poor health and a lower quality of life.

Dr. Denise Pate, a board-certified medical professional and Medical Director at Medical Offices of Manhattan who was not engaged in the current study, provided additional details regarding the harm peripheral neuropathy causes:

Peripheral nerves are responsible for detecting sensations of touch, pain, and warmth. When these nerves are harmed by high blood sugar levels, the body is no longer able to perceive these stimuli. This can cause discomfort and, even worse, put a diabetic at danger of failing to notice minor damage to their extremities. These minor wounds carry the risk of skin and bone infection and, ultimately, amputation.

Bariatric surgery is recommended?

Obesity is a condition that some type 2 diabetics may also have. Some surgical treatments may be suggested by doctors as a result of these contributing variables.

There are several different bariatric surgery choices, and they can help in maintaining weight loss. For those who have had trouble reducing weight through other methods including diet and exercise, these solutions might be helpful.

Without participating in the study, Dr. Mir Ali, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Centre at Orange Coast Medical Centre in Fountain Valley, California, told that “the indications for bariatric surgery currently accepted by most insurance carriers is a BMI greater than 40 or 35 with additional comorbid conditions, such as diabetes, hypertension, or sleep apnea.”

“The goal with surgery, which has been demonstrated in many studies, is to resolve or improve comorbid conditions, increase life expectancy, and improve the quality of life,” he continued.

Bariatric surgery benefits for diabetes

This prospective cohort study examined the effects of bariatric surgery on metabolic risk variables and the reduction of diabetic complications. The components of the analysed metabolic risk factors included weight, cholesterol, and blood sugar levels.

79 patients who underwent bariatric surgery and finished the 2-year follow-up were included in the study. All subjects had obesity of class 2 or 3.

The data revealed a decrease in peripheral neuropathy after two years. Cardiovascular autonomic neuropathy and retinopathy remained constant. Additionally, participants’ quality of life and pain levels improved, according to researchers.

The majority of the metabolic risk indicators, including weight loss, showed improvement. They also discovered a link between improvement in retinopathy and improvement in fasting glucose levels.

Benefits of weight-loss surgery

In the 18 to 24 months following surgery, the majority of patients lose 50 to 80% of the extra weight. But following surgery, the impacts on blood sugar start happening right away (within days). Patients who have this procedure can decrease or stop taking their diabetes medications.

Particularly helpful at managing diabetes is Roux-en-Y surgery. After surgery, about 33% of these patients do not require diabetes medication. 85% of patients are medication-free within two years of surgery. Their diabetes is no longer an issue.

People with a kind of diabetes that does not require medication and those with diabetes for less than five years have a higher likelihood of experiencing complete remission from the disease.

The dangers of weight loss surgery

The following are possible risks linked to these procedures:

  • Anaesthesia doesn’t work well.
  • surgery-related harm to neighbouring organs.
  • Bleeding.
  • production of blood clots.
  • Infection.
  • The tissue that surrounds and supports the internal organs in the abdomen experiences peritoneal inflammation, or peritonitis.

Additional dangers comprise:

  • the intestines are blocked.
  • development of kidney and gallstones.
  • Anastomotic stenosis is the medical term for narrowing of the stomach-to-intestine opening.
  • Early and late dumping syndromes include nausea, abdominal pain, and vomiting after eating.
  • Malnutrition.

limitations of the study and further research

There were certain restrictions on the study. First of all, there were not enough volunteers and there was no control group. Additionally, some of the patients who underwent bariatric surgery made it challenging for the researchers to follow up with them.

The fact that they were then constrained by the follow-up period shows the need for research that focus more on the immediate impacts and have even longer follow-up periods. There is a need for future studies with a wider range of participants because more than 98% of the participants were non-Hispanic and more than 73% were women.

The results of the study do not prove a causal connection between the variables they looked at. Further research into this topic may shed more light on the subject because researchers only employed particular assessments of peripheral neuropathy.

When reviewing the study’s findings, D.R. Pate issued the following warnings: The type of bariatric surgery was also not thoroughly analysed in that of the 79 patients, 71 received sleeve gastrectomy and 8 got gastric bypass surgery. We may conclude that weight loss in general, and not necessarily the method through which the weight loss occurred, was crucial to the outcomes as the type of technique was not further evaluated for the outcome.

Dr. Callaghan stated that he and his associates “We are currently conducting a study to see which treatment for peripheral neuropathy, exercise, bariatric surgery, or both, helps the most.”

He explained, “This is a randomised trial that will offer even more reliable information on the effects of exercise and bariatric surgery on peripheral neuropathy.”


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