Considering Metabolic Surgery for Type 2 Diabetes

By Alan L. Rubin

Metabolic surgery has been so successful in preventing and reversing diabetes that many surgeons and diabetes specialists consider diabetes a surgical disease. The surgery leads to marked and long-lasting weight reduction. When the effects of metabolic surgery are compared with standard (nonsurgical) care, the results are unequivocal.

The following sections introduce you to the benefits of surgery over medical treatment for type 2 diabetes with respect to weight loss, cost, and more.

Considering costs of metabolic surgery

Unfortunately having diabetes is expensive. A study by the Centers for Disease Control and Prevention in the American Journal of Preventive Medicine in August 2013 indicated that a man diagnosed with type 2 diabetes who is between the ages of 25 and 44 will incur related costs of $124,700 over his lifetime whereas a woman will incur costs of $130,800 over her lifetime. Half of that cost results from the treatment of complications of diabetes. In contrast, the average cost for metabolic surgery for diabetes is much cheaper at $22,000 in 2013.

Of course, the monetary costs represent only a small part of the cost of having diabetes. The psychological, social, and emotional costs are enormous. The reduction in the quality of life and the length of life is a major factor. The possibility of blindness, kidney failure, nerve disease with pain, and limitation of motion as well as heart attacks, strokes, and amputations are constant for a person with diabetes especially as he or she ages.

Two studies, the Diabetes Control and Complications Trial for type 1 diabetes and the Diabetes Prevention Program for type 2 diabetes, have shown that controlling the blood glucose for even a few years has major benefits 15 or 20 years later in the prevention of complications of diabetes. Even though metabolic surgery doesn’t cure everyone, it’s reasonable to expect that even a few years of improved glucose control can have substantial benefits in the long run. Consider the benefit for a person who had to take insulin and is now free of injections, even if he isn’t cured of his diabetes.

Contemplating the other benefits of metabolic surgery

If you have always wanted to play the piano or dance the samba, don’t expect metabolic surgery to bring about either one although you may feel so good and motivated by the results of surgery that you’re up to doing both. You may encounter a number of healthy changes brought on by successful metabolic surgery. Here are some of them:

  • Sleep apnea will improve and may disappear.

  • Snoring will improve and may disappear.

  • High blood pressure will disappear or greatly improve so you don’t need medications.

  • High abnormal blood fats will improve, and you may be able to stop medications.

  • Gastroesophageal reflux with heartburn will improve or disappear.

  • Metabolic syndrome, which leads to heart attacks, will improve.

  • Asthma will improve.

  • Arthritis will improve.

  • Women who have a history of infertility due to polycystic ovarian syndrome (see Chapter 6) may become fertile after surgery. Avoid pregnancy for the first 24 months after surgery when weight loss continues.

  • Abnormal liver function tests will improve.

  • Early diabetes complications may reverse or at least not worsen.

  • If you have little or no sexual activity before surgery, your enhanced physical and mental function after surgery as well as your increased feeling of attractiveness will probably lead to much more sexual activity after surgery if you so desire.