Diabetes and Obesity - What You Can Do About It


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Diabetes and Obesity - What You Can Do About It

Bariatric surgery also known as weight loss surgery is a quick and effective way for anyone dealing with Type 2 diabetes and obesity. It’s estimated roughly 13% of adults in the United States have diabetes, according to a 2020 report from the Centers for Disease Control and Prevention (CDC). Plus, nearly half of all people with diabetes suffer from obesity, which means they have a body mass index (BMI) over 30.
In fact, there is a strong link between obesity and the risk of developing type 2 diabetes. If a person has diabetes, their doctor may recommend losing weight as part of their treatment plan.

So What Can You Do About It?

There is a strong connection between obesity and diabetes. Carrying excess weight is a major risk factor for Type 2 diabetes. Most people who have Type 2 diabetes — more than 90% — are overweight. The link between obesity and diabetes occurs by a progressive defect in insulin secretion coupled with an accelerating increase in insulin resistance. Both insulin resistance and defective insulin secretion occur prematurely in obese individuals, and both worsen as diabetes takes hold.
Bariatric surgeryis a weight loss procedure that healthcare professionals recommend for many individuals with obesity and associated life-threatening illnesses like diabetes. Many bariatric surgeons are also increasingly recommending it to treat type 2 diabetes in people with obesity. Bariatric surgery can improve type 2 diabetes by lowering blood sugar and reducing the need for medications. This surgery has even resulted in long-term or permanent remission from diabetes. Yet, bariatric surgery is considered a major surgery, and it does carry some short- and long-term risks and side effects.

Bariatric surgery for diabetes

Bariatric surgery refers to a group of surgical procedures that help a person lose weight by changing their digestive system. This procedure typically makes a patient’s stomach much smaller, which helps to get a full feeling in their stomach sooner and eat less food overall. The surgery also limits the ability of the small intestine to absorb calories from food. Bariatric surgery can also affect certain hormones to reduce a person’s appetite and improve how their body metabolizes fat and uses insulin.
Because individuals with type 2 diabetes become resistant to insulin, bariatric surgery helps to treat the diabetes.Research suggests that bariatric surgery can help people with type 2 diabetes better control their blood sugar levels in addition to improving weight loss, cholesterol levels, blood pressure, and kidney function.
Healthcare professionals are increasingly recommending it for people with obesity and comorbid conditions such as heart disease and diabetes.

Types of Bariatric Surgery

Several types of bariatric surgery decrease the amount of food a patient can eat at one time. Some procedures also reduce the absorption of nutrients.The following sections will look at the different types of bariatric surgery in more detail.

Gastric bypass (Roux-en-Y)

For this permanent procedure, a surgeon staples off the top part of the stomach from the rest of the organ. The resulting pouch will only be able to hold about an ounce of food. The surgeon then cuts a lower part of the small intestine and attaches the pouch to it. This reduces the amount of time that food spends in the small intestine. The less time that food stays there, the less the body absorbs it. Learn more about it here

Vertical sleeve gastrectomy

This surgery is sometimes also referred to as stomach stapling. It works by permanently removing about 80% of the stomach to leave just a long pouch. It is not necessary for the surgeon to reroute the intestine for this procedure. Learn more about sleeve gastrectomy here.

Laparoscopic adjustable gastric banding

In this procedure, a surgeon makes small incisions in the abdomen. They insert a tube with a camera called a laparoscope through the incisions and insert a band on the upper part of the stomach. Learn more about it at our Duodenal Switch service page.

Other Types of Bariatric Surgeries

Some other, less frequently used types of bariatric surgery include the duodenal switch and the Maestro system, which use an implantable device that reduces appetite.

Risks of Bariatric Surgery

As with any surgery, bariatric surgery poses some risks. These include:
  • Dumping syndrome, which refers to when food enters the small intestine rapidly, resulting in abdominal pain, sweating, nausea, and vomiting
  • Leaks in the gastrointestinal tract
  • Inflammation of the lining of the abdomen
  • Infections
  • Reactions to the anesthetic the surgeon used during the procedure
After surgery, patients will not be able to absorb as many nutrients. For this reason, patients are advised to take vitamin and mineral supplements according to their doctor’s recommendations. Following doctor’s orders helps reduce the risk of significant nutritional deficiencies — such as chronic anemia, vitamin B12 deficiency, and vitamin D deficiency — which can lead to other complications over time. Luckily the rate of death from bariatric surgery is extremely low. In fact, the American Society for Metabolic and Bariatric Surgery estimates that the risk of death is 0.16% within 30 days of surgery.

Other Potential Side Effects

Possible side effects directly following bariatric surgery may include:
  • bleeding from the site where the surgeon sewed the sections of the stomach together
  • diarrhea
  • blood clots
Later on, side effects may include:
  • an inability to absorb enough nutrients, which can lead to anemia and osteoporosis gallstones
  • narrowing of the new stomach or the connection between the stomach and the small intestine (strictures)
  • hernias
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Are You a Candidate?

Before considering bariatric surgery, your surgeon will typically ask whether you have tried weight loss methods such as exercising, diets or weight loss medications.
Your surgical team will also evaluate your risks before recommending surgery.
Typically, your surgeon will recommend surgery if you have:
  • a BMI over 40, even if your diabetes is well controlled through the use of medications
  • a BMI between 35 and 39.9 and diabetes that is not well controlled with medications
  • a BMI between 30 and 34.9, diabetes that is not controlled with medications, and other major weight-related health conditions
You may not be a candidate for bariatric surgery if you have any of the following conditions:
  • an inflammatory condition of the gastrointestinal tract, such as Crohn’s disease
  • a history of previous bowel surgery or trauma
  • a serious heart or lung disease
  • recently recovered from a heart attack or stroke
  • undergone long-term steroid treatment
  • an allergy to any of the materials used during surgery diagnosed with an serious illnesses, such as cancer, pancreatitis, or liver disease diagnosed an untreated or unstable mental health condition
  • portal hypertension (refers to elevated pressures in the portal venous system. Venous pressure more than 5 mm Hg greater than the inferior vena cava pressure is defined as portal hypertension.
  • diagnosed with a substance use disorder

Insurance Coverage

Care creditalong with most large insurance companies as well as Medicare and Medicaid cover bariatric surgery for those who meet certain criteria. A person should reach out to their insurer directly to learn more about these guidelines.
For example, some insurance companies may require a person to have a BMI over 40 with proof from a healthcare professional that previous medically supervised weight loss programs made no impact.

Estimated Costs With Insurance

Other insurers may cover the surgery if a person has a BMI between 30 and 39.9 and at least one significant associated life-threatening illness like heart disease, diabetes, or sleep apnea. In most cases, you will need to pay for a portion of care out of pocket, even if you have health insurance. The cost of surgery could still be several thousand dollars, but it may be as low as $0 depending on your plan, your deductible, and your out-of-pocket maximum. It is a good idea to contact your insurer first to review exactly what your insurer will pay.

Ballpark Costs Without Insurance

Without insurance, bariatric surgery can cost between $15,000 and $25,000 depending on the procedure you choose. The average cost of gastric bypass surgery is around $23,000 while the cost of gastric banding, sleeve gastrectomy and gastric mini sleeve surgery costs are lower around $15,000. Discuss costs with your surgeon’s team as surgery fees fluctuate depending on what part of the country you live in.

What You Can Expect Long-term

The long-term benefits of bariatric surgery includes:
  • improvements in type 2 diabetes, high blood pressure, heart disease, high cholesterol, kidney disease and sleep apnea
  • improvements in knee, hip, and other body pain
  • improved mental health prolonged life
  • a reduced need for prescription medications, including insulin
  • lower medical costs
Regular follow-up visits are necessary. Healthcare professionals will monitor a person’s weight and look for signs of potential complications such as diet or vitamin deficiencies.
Long-term studies suggest that your weight loss and other benefits associated with your bariatric surgery lasts for many years. Moreover, some research suggests that those with diabetes who have undergone bariatric surgery are often able to stop taking insulin altogether.
The greatest benefits appear to be in those who subscribe to a healthy, low calorie diet, get regular physical activity, have a good sleep regimen and attend follow-up appointments with their doctor.

Your Takeaway

Bariatric surgery is an effective tool against obesity and type 2 diabetes. It may be an option for you if your obese, have diabetes and have been unable to lose weight via exercise, diet or other weight loss medications.
For optimal results, besides opting for bariatric surgery to treat your type 2 diabetes or other life threatening illnesses, you’ll need to follow a lifelong maintenance of diet, exercise, and regular healthcare visits.
Losing an excessive amount of weight takes courage, discipline, and commitment but you’re not alone. NOVA Bariatrics and Minimally Invasive Surgery understands your goals in treating weight loss and obesity, and is with you throughout your entire weight loss journey. Dr. Alibhai and the team at NOVA Bariatrics and Minimally Invasive Surgery have the experience, expertise and state-of-the-art equipment to help you find the best, robotic and non-invasive solution to reduce your weight and restore your health.

Why NOVA Bariatrics?

Over time, obesity along with breathing issues or other life-threatening diseases will cause a breakdown in your body’s systems. This can lead to a deterioration in your health and significantly decrease your life expectancy. Robotic-assisted bariatric surgery is a powerful tool that lets us reverse and prevent you from contracting life-threatening diseases like breathing issues, diabetes, heart disease, gout, cancer and many others associated with extreme obesity.
Dr. Mustafa H. Alibhai, MD, FACS, FASMBS is expertly trained in minimally invasive and robotic surgery. He performs a wide range of weight loss and bariatric surgeries. Dr. Alibhai and the surgical team at NOVA Bariatrics understand your weight loss goals and will recommend weight loss options to treat your obesity. Together, their combined experience and expertise go a long way to help those who have been unable to achieve significant weight loss through dieting and exercise alone.

Contact NOVA Bariatrics Today

Ready to reinvent yourself, gain more confidence, treat any weight-related illnesses like diabetes, and experience lasting weight loss? Then contact Dr. Alibhai or our team at NOVA Bariatrics today and either book online or call us at 459-639-0953. We have convenient offices in Irving and Arlington, TX and we’re waiting to help you achieve all your weight loss goals.


Disclaimer – The information on this website is for general information purposes only. Nothing on this site should be taken as advice for any individual case or situation. All blogs are meant to be educational. We advise consulting with a professional before attempting anything written in a blog.