Weight loss surgery is now recommended as a treatment for patients with type 2 diabetes who have a body mass index (BMI) of greater than 35 kg/m2. The resulting weight loss can lead to an improvement or resolution of diabetes in up to 84% of patients.
Among the different types of weight loss surgery available, the BPD/DS procedure (Biliopancreatic Diversion with Duodenal Switch) appears to be the most effective for diabetes treatment. This procedure involves two components. First, a portion of the stomach is removed, creating a smaller, tubular stomach pouch. Then, the first portion of the small intestine is divided just past the stomach, and a portion of the last section of the small intestine is connected to the stomach in its place. This results in a much shorter section of small intestine for the food to pass through, and far fewer calories, especially from fat and protein, being absorbed. This method of surgery will also result in patients eventually being able to eat normal size meals. This procedure unfortunately does have a higher risk of complications than other weight loss surgeries, and is more likely to cause protein and vitamin deficiencies.
All of the weight loss surgery procedures improve blood sugar by multiple mechanisms. The most significant improvements are due to changes in gut hormones that reduce hunger and produce satiety (a feeling of fullness) and the decrease in caloric intake. Loss of fat tissue may help to reduce insulin resistance also.
With any weight loss surgery, there are possible complications, and a strict diet must be followed. Patients should be diligent about keeping all follow up appointments to avoid potential post-surgical problems and nutritional deficiencies.
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