Bariatric surgery, or weight loss surgery, has been shown to be effective in treating type 2 diabetes, especially in obese individuals. This procedure not only helps with significant weight loss but also plays a role in improving glycemic control and, in some cases, leading to diabetes remission.
How Bariatric Surgery Works in Treating Diabetes:
- Significant Weight Loss: By reducing the size of the stomach or changing the digestive tract, food intake is reduced, leading to weight loss. This weight loss improves insulin sensitivity and glycemic control.
- Hormonal Changes: Bariatric surgery affects gut hormones that regulate hunger, satiety, and glucose metabolism, such as increased secretion of incretin hormones that increase insulin secretion.
- Gut Microbiota Changes: Several studies have shown that this surgery changes the composition of the gut microbiota, which may contribute to improved glucose metabolism.
Effectiveness of Bariatric Surgery:
A study published in Current Diabetes Reports reported that bariatric surgery can result in diabetes remission in 33–90% of individuals one year after surgery, compared with 0–39% in those who received conventional medical therapy. Although remission rates decline over time, they remain higher in individuals who undergo surgery compared with those who do not.
Additionally, another study published in The New England Journal of Medicine reported that five years after surgery, patients who underwent bariatric surgery showed an average reduction in HbA1c levels of 2.1%, compared with 0.3% in those who received intensive medical therapy without surgery.
Considerations and Risks:
While bariatric surgery offers significant benefits, it also carries risks, including surgical complications and the need for long-term lifestyle changes. Therefore, a thorough evaluation by the medical team and the patient's commitment to following post-operative recommendations are essential to achieving optimal results.
In Indonesia, bariatric surgery is starting to be known as one of the solutions for obese type 2 diabetes sufferers. According to the Indonesian Ministry of Health, after undergoing bariatric surgery, patients must commit to changing their lifestyle, accompanied by awareness and discipline, and undergo consultation sessions with nutritionists.
Overall, bariatric surgery is an effective intervention for the treatment of type 2 diabetes in individuals with obesity, with multiple mechanisms contributing to improved glycemic control and potential diabetes remission.
Article written by dr. Handy Wing, Sp.B, Subsp.BD(K), FBMS, FICS, FInaCS (Surgeon Specialist – Digestive Surgery Subspecialist, EMC Alam Sutera Hospital).