Our Summary

This research paper discusses the growing evidence that shows gastrointestinal surgery (like bariatric surgery) can have positive effects on diabetes, regardless of the patient’s weight loss or initial body mass index (BMI). This challenges old guidelines from the US National Health Institutes that focused only on BMI. The Second Diabetes Surgery Summit, working with major diabetes organizations, developed new guidelines that determine surgery eligibility based on the severity of a patient’s type 2 diabetes and how well it’s being managed medically, while considering obesity as just one factor, not the only one. This is the first time that these types of surgeries have been included in the treatment options for type 2 diabetes.

FAQs

  1. Can gastrointestinal surgery have positive effects on diabetes regardless of the patient’s weight loss or initial BMI?
  2. What is the basis for determining surgery eligibility according to the new guidelines developed by the Second Diabetes Surgery Summit?
  3. Is this the first time that gastrointestinal surgeries have been included in the treatment options for type 2 diabetes?

Doctor’s Tip

A doctor might tell a patient considering obesity surgery that it can have positive effects on diabetes, regardless of the amount of weight lost. The focus should be on the severity of the diabetes and how well it is being managed medically, with obesity being just one factor to consider. It is important to discuss these new guidelines and treatment options with your healthcare provider to determine the best course of action for managing your diabetes.

Suitable For

Patients who are typically recommended for obesity surgery include those with a BMI of 40 or higher, or a BMI of 35 or higher with obesity-related comorbidities such as type 2 diabetes, hypertension, sleep apnea, or high cholesterol. Additionally, patients who have tried and failed to lose weight through diet and exercise may also be considered for obesity surgery. The new guidelines mentioned in the research paper suggest that patients with severe type 2 diabetes that is not well-controlled with medication may also be candidates for obesity surgery, regardless of their BMI. It is important for patients to undergo a thorough evaluation by a healthcare provider to determine if they are suitable candidates for obesity surgery.

Timeline

Before obesity surgery:

  1. Patient consults with a healthcare provider to discuss surgical options for obesity and related health issues.
  2. Patient undergoes medical evaluation to determine eligibility for surgery, including assessments of BMI, overall health, and potential risks.
  3. Patient attends pre-operative counseling and education sessions to understand the surgery process, risks, and post-operative expectations.
  4. Patient may be required to follow a specific diet and exercise regimen to prepare for surgery and reduce risks.

After obesity surgery:

  1. Patient undergoes surgery, which may involve procedures such as gastric bypass, gastric sleeve, or gastric banding.
  2. Patient stays in the hospital for a few days for monitoring and recovery.
  3. Patient follows a strict post-operative diet and exercise plan to support weight loss and prevent complications.
  4. Patient attends regular follow-up appointments with healthcare providers to monitor progress, adjust medications, and address any concerns.
  5. Patient experiences weight loss and improvements in health conditions such as diabetes, hypertension, and sleep apnea.
  6. Patient may require additional support from dietitians, psychologists, and support groups to maintain long-term success and prevent weight regain.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with obesity surgery?

  2. How will my diabetes be affected by the surgery?

  3. Will I still need to take medication for diabetes after the surgery?

  4. How much weight can I expect to lose after the surgery?

  5. How will my diet and exercise routine need to change after the surgery?

  6. How long is the recovery period after obesity surgery?

  7. Are there any specific dietary restrictions I need to follow after the surgery?

  8. How often will I need to follow up with my doctor after the surgery?

  9. Will I need to see a dietitian or nutritionist for guidance after the surgery?

  10. How will my overall quality of life be impacted by the surgery?

Reference

Authors: Cohen RV, Shikora S, Petry T, Caravatto PP, Le Roux CW. Journal: Obes Surg. 2016 Aug;26(8):1989-91. doi: 10.1007/s11695-016-2237-6. PMID: 27189354