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Bariatric Surgery for Type 2 Diabetes

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Are you Type 2 Diabetic and overweight? Bariatric surgery with Streamline could help you lose weight AND put your diabetes into remission.

“Prior to the surgery I was insulin dependent, injecting twice a day in an effort to keep blood sugars in check. I had a restricted driving licence and had to check my blood sugar before every journey and every two hours when driving. Twelve months after surgery I have been signed off as non diabetic by my GP and the DVLA have been informed that I am no longer on any diabetic medication thus removing licence limitations.” Mr RG LRYGB, Oct 2017

Surgeons first recognised how powerful a treatment bariatric surgery was for Type 2 Diabetes many years ago with a ground-breaking publication in the Annals of Surgery, a prestigious American Medical Journal.

Over the last 20 years more and more evidence has highlighted that weight loss surgery is an effective treatment for Type 2 diabetes.

“Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus”.Annals Surgery, 1995 Sep;222(3):339-50.

“Why surgery is the next big thing for Type 2 Diabetes” Nature, 26 May 2016

“One of the most significant changes in treating diabetes since the discovery of insulin in 1921” New Scientist 28 May 2016

“Surgery should be an option for diabetics” Time Magazine

Bariatric surgery for diabetes: How does it work?

There are a number of procedures that come under the banner of bariatric surgery. However, the main 3 procedures are; gastric band, gastric bypass and gastric sleeve. The evidence shows that the laparoscopic gastric bypass is the most effective operation for metabolic illnesses, but the laparoscopic gastric sleeve isn’t far behind.

But why is the gastric bypass surgery most effective? The gastric bypass causes significant changes in:

  • Gut hormones, that are involved in appetite control
  • Secretion and absorption of bile acids
  • The gut organisms that colonise the gut; our microbiome
  • Nutrient sensing

The interaction of these four changes causes

  • Increased insulin secretion
  • Increased insulin sensitivity
  • Increased appetite control and weight loss

Scientific studies indicate that up to 80% of obese adults with Type 2 diabetes experience a complete remission of their diabetes within five years after gastric bypass surgery, and so are able to reduce or cease their insulin medication.

Bariatric surgery for diabetes: Who is eligible?

Diabetes UK has published the guidance below – see here for more information

The guidance is based on the opinion of 48 experts in the field of diabetes and metabolic surgery, including 12 surgeons, 28 diabetologists, 12 surgeons, cardiologists, dieticians, gastro-enterologists and general physicians. These experts came together to form an expert committee, which evaluated all the medical evidence published.

  • BMI over 40
  • BMI of over 35 where hyperglycemia is inadequately controlled (without insulin)
  • BMI of over 30 where hyperglycemia is inadequately controlled (despite insulin)

Bariatric Surgery: Which is the best operation?

As mentioned earlier, the evidence shows that the gastric bypass is the most effective operation for metabolic illnesses, but the gastric sleeve isn’t far behind.

No single weight loss operation is perfect with pros and cons for each. Call Streamline on 0333 016 3030 or make an online enquiry to book an initial consultation with a Streamline Surgeon, who will help you choose the operation best suited to you based on your Age, Sex, BMI, diet, expectations and metabolic illnesses.

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