What is diabetes and can I benefit from metabolic surgery if I have diabetes or other health conditions?

By: Dr. Michelle Cordoba-Kissee
DHR Health Bariatric Institute

Diabetes mellitus is a disorder in which the sugar levels in the blood and urine get too high, typically due to an issue with insulin.  Insulin is a hormone made by the pancreas which helps our bodies use sugar for energy.  With type 1 diabetes, the pancreas does not make enough insulin, and patients need to take insulin in order to survive.

The more common type of diabetes is type 2 diabetes.  This tends to occur in the setting of being overweight.  As a person gains weight, their body becomes resistant to insulin, and they will require higher levels of insulin to control their blood sugars.  Over time, the pancreas can become damaged. Type 2 diabetes is best treated by maintaining a healthy weight, and often pills and injected medications including insulin are used to help bring high blood sugars into range.

Can type 2 diabetes be cured?  Many doctors argue that for diabetes to be considered “cured”, we would need to demonstrate that the damage previously done to the pancreas has been reversed.  For this reason, we typically say that a person’s diabetes can go into remission.  Maintaining a healthy weight by activity, nutrition and sometimes medications or surgeries can help reverse type 2 diabetes.  Metabolic surgery can help many people put their diabetes into remission.   In general, the longer a person has had diabetes, the more damage has occurred to the pancreas and the more difficult it will be for the diabetes to go into remission.

Does metabolic surgery help with type 2 diabetes?  Yes, metabolic surgery (also called bariatric or weight loss surgery) is one of the most effective treatments for type 2 diabetes.  Long term, people who have metabolic surgery see benefits from their weight loss in terms of high blood pressure, sleep apnea, gastric reflux disease, high cholesterol, joint pain and diabetes.  However, most people also notice immediate improvement in their blood sugar control right after their surgery, even before they start losing weight.  Because of some of the hormone changes after surgery, most of our patients do not need any medications for their blood sugar when they go home from surgery.  Those patients that still need medications for their blood sugars typically take fewer medications and at lower doses.

Am I a candidate for metabolic surgery?  People who have a body mass index (BMI) of more than 35 or 40, plus a weight related problem, such as diabetes or high blood pressure, may benefit from metabolic surgery.  You can calculate your BMI at: https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm.

If you or someone you know would like more information on the health benefits of metabolic surgery, please call the DHR Health Bariatric Institute at (956) 362- LOSE (5673).