Bariatric Surgery as Treatment Option for Type 2 Diabetes

Updated: Sep 12

Bariatric surgery is an umbrella term that refers to a group of procedures that alter how the digestive system works to help an individual lose weight. Note that bariatric surgery is not a quick and easy weight loss solution suitable for everyone, but rather a medical procedure that is recommended to selected individuals who are very overweight or obese, and diagnosed with a weight-related health problem.


In this case, bariatric surgery may be performed to address symptoms of type 2 diabetes.



Type 2 Diabetes

Type 2 diabetes is a chronic medical condition that occurs when the body fails to produce enough insulin or is unable to effectively use insulin. As a natural hormone, insulin is created by the pancreas, which plays a key role in digestion and the regulation of blood sugar (glucose). The role of insulin is to help the body process glucose from the blood to be used for energy. With diabetes, the lack of insulin causes the body to accumulate high levels of glucose, which can damage the kidneys, heart, blood vessels, nerves and eyes.


Bariatric Surgery for Type 2 Diabetes

Weight loss surgeries can aid in the treatment of type 2 diabetes. Depending on the overall health and needs of the patient, bariatric surgeons can use any of the following techniques:

  • Roux-en-Y gastric bypass – This procedure involves creating a small pouch from the top part of the stomach and connecting it to the small intestine. This results in the patient feeling full after eating a small amount of food, and because the swallowed food bypasses most of the stomach and small intestine, the body absorbs fewer calories and nutrients, resulting in weight loss.

  • Biliopancreatic diversion with duodenal switch (BPD-DS) gastric bypass – Considered to be the most effective bariatric surgery to address type 2 diabetes, the duodenal switch combines a sleeve gastrectomy with a gastric bypass. This results in the creation of a sleeve-like stomach to restrict the amount of food, and which is connected to the last part of the small intestine to restrict the calories absorbed by the body.

  • Laparoscopic sleeve gastrectomy – This procedure involves creating a smaller sleeve from the stomach, which makes the patient feel full quicker, thus restricting the amount of food he or she eats.

  • Laparoscopic adjustable gastric band – This involves placing a band around the top portion of the stomach, which creates a smaller pouch to hold food. Like gastrectomy, this works by limiting the amount of food that the patient eats and makes him or her full quicker.


These forms of bariatric surgery not only limit the amount of food or calories being taken by the body. They also help to reduce the absorption of sugar, leading to a decrease in blood sugar levels for those with diabetes.


Who is Eligible?

Bariatric Surgeons in Singapore may recommend weight loss surgery to patients who meet the following requirements:

  • Have a body mass index (BMI) of 40 or more

  • Diagnosed with type 2 diabetes or other medical conditions that are related to obesity or excessive weight such as heart disease

  • Have not been able to achieve a normal fasting blood sugar through conventional means


Benefits

There are many benefits that bariatric surgery can bring to eligible patients:

  • Significant weight loss

  • Getting full easily, resulting in less eating and cravings

  • Hormonal change in the gut that affects how the body produces insulin

  • Possible remission of diabetes

  • Restoration of glycemic control by enforced caloric restriction

  • Improved insulin sensitivity by increasing the amount of bile acids

  • Enhanced insulin secretion leading to lower blood sugar levels


Recovery

The recovery rate for patients who undergo bariatric surgery in Singapore depends on the type of the surgery. Most patients are cleared to leave the hospital after 1 to 3 days. However, it may take 3-5 weeks for patients to be able to return to their usual lifestyle. Recovery also involves incorporating a change in lifestyle in terms of diet and exercise.

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