Has diabetes actually been cured by surgery? For many people, the answer is yes.
Many patients with diabetes no longer take insulin after weight-loss surgery, and they are often able to stop medications within a day or two after surgery. After three years, many people with diabetes no longer take any diabetes medications at all.
Even the American Diabetes Association now enthuses: "It's hard to dispute that in the fight against Type 2 diabetes, weight-loss surgery trounces medication and lifestyle changes in severely obese people."
Our experience at St. Luke's University Health Network shows that surgical management of diabetes is just beginning to help people take control of this ravaging disease.
We see people just coming out of surgery showing no symptoms of diabetes — an ability to maintain normal blood glucose levels without medication — long before they have achieved any significant weight loss. Clearly weight loss is not the driving factor for diabetes reversal in these cases.
There are numerous studies and theories about what can cause such an immediate and dramatic reversal of Type 2 diabetes. While no conclusive scientific proof of the causes has emerged, one thing is clear: Weight-loss surgery is a safe, effective method to cure diabetes for many.
These results suggest that weight-loss surgery should be available to help many other people, not just the severely obese.
Weight-loss surgery is offered to patients who have a body mass index greater than 35 who also have an associated serious health condition such as diabetes, high blood pressure or sleep apnea. The surgery is also available to any patient with a BMI of 40 or greater. However, some surgeons are already performing experimental surgeries on people with diabetes who have lower BMIs.
These guidelines from the National Institutes of Health were established nearly 20 years ago and have never been revised or updated. With increasingly less invasive procedures such as laparoscopic approaches, weight-loss surgery has become even more effective and safe. At St. Luke's, our clinical outcomes for mortality, readmissions and length of stay are far better than the national average. Our quality data is based on performing more than 2,000 procedures.
Additionally, patient outcomes continue to improve as well. Quality-of-life issues beyond weight loss, such as lower cholesterol and blood pressure and improved sleep, make life better overall for many patients. In addition to critical health improvements, weight-loss surgery patients often benefit from increased self-esteem and regain control over simple things in life, such as walking without being winded and sitting in an average size chair.
Weight-loss surgery in reversing diabetes eliminates or reduces the need for insulin and other medications and gives people more control over their lives and health.
In general, people who undergo this procedure soon after being diagnosed with diabetes also benefit from preventing many of the long-term complications of the disease, which may include neuropathy, blindness, non-healing wounds and heart disease.
The International Diabetes Federation calls for bariatric surgery to be considered earlier in the treatment of eligible patients to help stem the many complications that can result from diabetes, and not only as a last resort to treat this illness.
A team of doctors and other health care professionals working together should suggest if surgical management of diabetes may be right for each individual. As health care costs continue to be highly scrutinized and providers seek ways to provide the best care for their patients, weight-loss surgery may provide a win-win situation as a cost-effective solution for diabetic patients — as well as a cure.
Dr. Leonardo Claros is section chief of bariatric surgery and medical director of the bariatric surgery program for St. Luke's University Health Network. Dr. Maher El Chaar serves as co-medical director of St. Luke's bariatric surgery program.