Diabetes and Gastric Sleeve Surgery: Part 1

For years, my team and I have seen patients with Type II diabetes improve and even resolve this condition after gastric sleeve in our Mexico hospital. More and more studies are coming out every day to prove what we’ve known all along: vertical sleeve gastrectomy is perhaps the best tool in the fight against the devastating effects of Type II diabetes.

Many of my patients go into VSG as a diabetic or as a pre-diabetic. But even if they haven’t been diagnosed yet, we know that being overweight or obese makes you a prime candidate for the disease. And once you have it, losing weight is one of the only ways to reduce or eliminate its impact on your health. Traditionally, the medical community has relied on medication, advice about changing the patient’s diet, and counsel to add more exercise. Maybe that sounds eerily similar to the advice you’ve gotten about how to lose weight. And as we all know, it’s not that easy.

Why Surgery?
Standard diet-and-exercise advice fails for many overweight and obese people, no matter why you’re doing it. In other words, whether you want to lose weight to look better in your jeans or you want to improve your Type II diabetes, your body doesn’t want to let that weight go. And that’s why gastric sleeve surgery is necessary for a significant number of patients.

One investigation, published in Study for Obesity and Related Diseases, compared two groups of obese people with Type II diabetes: one of which was treated with traditional lifestyle modifications and the other treated with sleeve gastrectomy. The results were shockingly different. All but one patient in the VSG group resolved their diabetes. Participants in that group also saw improvements in hypertension and obstructive sleep apnea syndrome. On the other hand, none of the people in the conventional medical therapy group eliminated their diabetes, nor did they get off hypertension medication or improve sleep apnea.

A larger study found in the Indian Journal of Endocrinology and Metabolism delivered a slightly different, though still thought-provoking result. It proved that bariatric surgery was a more effective long-term solution than lifestyle changes and medication. Even when patients initially used diet and exercise to improve their diabetes, half fell back into old habits that brought back their diabetes by the fourth year. The same thing happened to people who treated the disease with medication. It turns out that lifestyle and medication aren’t good solutions over the long haul. And that’s a problem.

That same study showed that with surgeries like vertical sleeve gastrectomy, however, patients lost a substantial amount of weight and kept all or most of it off in the years to come. VSG, it turns out, is a good short-term and long-term solution to diabetes. That’s thanks to weight loss, of course, but bariatric surgery also improves insulin action, while the hormone changes it creates also have positive effects in diabetic patients. The complexities of it all aren’t completely understood yet, but there’s no doubt about the results themselves.

Next week, we’ll take another look at how and why VSG can dramatically improve Type II diabetes, as well as which patients it seems to benefit the most.