Can You Reverse Type 2 Diabetes with Bariatric Surgery?

Can you reverse diabetes? It's possible with bariatric surgery. Obese people who don’t get this surgery are more likely to die of type 2 diabetes.

If you’ve been fighting unsuccessfully with your weight and blood sugar levels, you may already have had discussions with your doctor about your options. Both bariatric surgery and weight-loss medication are possible.

But allowing type 2 diabetes to go unchecked is the most dangerous move you can make.

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Weight-loss surgery and type 2 diabetes

The most common types of bariatric surgery for weight loss include:

• Gastric sleeve
• Roux-en-Y gastric bypass
• Adjustable gastric band

Bariatric surgery has become one powerful way to limit and even reverse type 2 diabetes. In one study of more than 1,350 patients with type 2 diabetes, 75 percent of patients had safe blood sugar levels one year after surgery. That number jumped to 79 percent after three years.

Your doctors will advise you about which type of surgery is best for you. All three procedures have about the same success, according to the study of 1,350 patients and others.

Over time, systematic reviews have found bariatric surgery can reverse type 2 diabetes for 58 to 95 percent of patients. While there’s no cure for the disease, surgery can lower your blood sugar levels to normal.

The chances of remission are higher in patients with fewer or less severe diabetes risk factors. Your doctors have several scoring systems to use when advising you. In general, it helps to be younger, have relatively low blood sugar levels, and to have had type 2 diabetes for a shorter period of time.

The drop in blood sugar often occurs about 48 hours after the surgery before significant weight loss. That change may last. In one long-term study of the Roux-en-Y procedure, more than half of the patients were still out of the diabetic range 12 years later.

As more teenagers have become obese and developed diabetes, doctors have noticed that their diabetes can be harder to treat. As a parent, you may hear that they should have weight-loss surgery before their diabetes becomes harder to manage.

Will you live longer?

Surgery may help obese diabetic adults live longer. In a Scandinavian study with data from 32 years, people who had weight-loss surgery lowered their mortality rate by more than 60 percent compared to obese people who did not.

In part, that’s because the surgeries also seem to protect patients from heart disease, a major killer when you’re carrying extra weight. The surgically treated group was dramatically less likely to die of heart disease, diabetes and, for up to 15 years, cancer.

Their mortality was still higher than that of the general population, however, and it increased over time.   

Medication for weight loss and type 2 diabetes

Injectable medication can tame your food cravings and appetite, lower your blood sugar, and protect your heart. Several new drugs can help you shed as much as 20 percent of your body weight — compared to older drugs that promised only about an 8 percent loss.

The best candidates are people with type 2 diabetes who are significantly heavier than doctors advise and are at risk for heart disease.

If your doctor suggests surgery, you may want to try medication first, although the drugs are very expensive if you don’t have insurance coverage — and even if you do — and may be hard to get.

The bottom line is you need to take diabetes seriously. You also should quit smoking and get at least a half hour of exercise every day.

After surgery, you will still need to eat less and skip soda and other products that raise blood sugar. Start now.

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