This study came out from my alma mater, Duke University. They followed 80 diabetic patients who had had the gastric bypass surgery between 2000-2004. Over the subsequent 11 years, their outcomes were compared to a similar group of 80 diabetic patients who did not have bariatric surgery. The group undergoing gastric bypass surgery had greater percentage of excess weight loss than the control group (66% vs. only 1.6%). More than half of the surgical patients had complete remission of diabetes and 6.4% had partial remission. In contrast, no patient in the control group had remission or improvement of diabetes. Furthermore, compared with the nonsurgical cohort, the group undergoing gastric bypass surgery had a significantly reduced incidence of
microvascular & macrovascular complications. These would be the dreaded complications of diabetes such as premature cardiac & other vascular disease, loss of eyesight, kidney damage, diabetic foot infections leading to amputations, and other similar pathologies.
For the past 15-20 years, bariatric surgeons have been preaching the health benefits of the Roux en-Y gastric bypass (and now the sleeve gastrectomy) in diabetics to our medical colleagues. It has nothing to do with weight loss, as we see improvement and even remission of diabetes almost immediately before any significant drop in weight. These are due to hormonal and other changes in the gastrointestinal system; changes that do not occur with adding more and more medications and eventually ending up on insulin. The longer the patients are diabetic, the likelier they are to develop the dreaded micro/macrovascular complications and the less effective the surgeries will be. In this study, 15% of the surgical patients went back on diabetes medications. Research has repeatedly implicated longer preoperative duration of diabetes and significant postoperative weight regain as the primary factors.
If your body mass index is over 30 and you suffer from diabetes, prediabetes, or other obesity related co-morbidities such as high blood pressure, elevations in cholesterol or triglycerides, and sleep apnea, you should look more closely at the vertical sleeve gastrectomy or the Roux en-Y gastric bypass. Many of our medical colleagues’ mindsets about bariatric surgery is stuck in the 80’s and 90’s and hence, their extreme hesitation to refer patients earlier for surgery when it will have the most benefit. What is done now, and how it’s done, is very different than before. Bariatric surgery has now become as risky as routine gallbladder or appendix surgery and less than other abdominal operations.
If you want to learn more about vertical sleeve, please attend one of our free information seminars where you can learn about different types of weight loss surgery. You can also attend one of our patient support meetings where you’ll hear first hand about gastric sleeve and gastric bypass patients’ success stories. You will find their respective schedules on our website’s calendar of events.