Surgery for Type 2 Diabetes - dummies

By American Diabetes Association

Eating healthy foods, exercising, losing weight, and of course, taking necessary medications like pills or insulin are all proven strategies to manage your blood glucose and prevent complications. But now, some people with diabetes have another effective option: surgery.

Surgery to treat diabetes is called metabolic surgery. It is also sometimes called bariatric surgery or weight-loss surgery. The goal of metabolic surgery is to treat diabetes while helping patients lose weight and reduce the risk of cardiovascular disease. Some patients don’t have to take diabetes medications anymore after surgery.

Several studies have shown that surgery can help people with type 2 diabetes improve their blood glucose and reduce their risk for cardiovascular disease. What’s incredible is that these surgeries improve blood glucose in ways that extend beyond just losing weight. Scientists are still investigating this phenomenon.

Who is eligible for surgery? You must be a good candidate for surgery in order to get metabolic surgery, so ask your healthcare provider whether this might be a good option for you. For example, people with substance abuse problems or mental health conditions might not be the best candidates for surgery.

Then you and your doctor will consider your BMI and blood glucose control. The American Diabetes Association has very specific guidelines on who is an appropriate candidate for metabolic surgery. Recently, the Association recommended metabolic surgery for people with type 2 diabetes who are morbidly obese (BMI greater than 40 kg/m²) and in people with type 2 diabetes with uncontrolled blood glucose and a BMI between 35–39.9 kg/m². The Association also said that metabolic surgery can be considered in people with type 2 diabetes with a BMI of 30–34.9 kg/m² if their blood glucose is not adequately controlled.

Consider and weigh the adverse effects: Surgery is expensive and can cause long-term side effects such as a dumping syndrome (nausea, colic, and diarrhea), risk for depression, vitamin and mineral deficiencies, and other issues.

The four most commonly performed metabolic surgeries are: roux-en Y gastric bypass, vertical sleeve gastrectomy, laparoscopic adjustable gastric banding, and biliopancreatic diversion.

Health insurance companies require different criteria for coverage of surgery, so do your homework. If you’re considering metabolic surgery, call your insurance carrier to find out more about your coverage and limits.