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Will Weight Loss Surgery Benefit Mildly Obese Diabetics? Overweight or obesity will affect a person’s ability to use insulin to properly control blood sugar levels. That is why overweight or obese people are more likely to develop diabetes. Almost 90 percent of people living with Type-2 diabetes, the most common form of diabetes, are overweight or obese. According to the Centers for Disease Control and Prevention (CDC), diabetes affects 29 million people in the United States. Diabetes can lead to many complications including nerve damage, eye complications foot complications and kidney disease. It also increases the risk of developing heart disease, high blood pressure, and stroke. More than 70,000 people die every year from complications linked to diabetes, as reported by the American Diabetes Association. Fortunately, Type-2 diabetes is largely preventable. Some studies have found that changes in lifestyle and small amounts of weight loss in the range of 5 to 10 percent can actually prevent or delay the development of Type-2 diabetes among high-risk adults. While some people can lose weight with lifestyle interventions including diet and moderate to intense physical activity like walking for 150 minutes per week, others just cannot. Those who cannot lose weight just by lifestyle changes may need to opt for weight loss operations or bariatric surgery that use various methods to shrink the size of the stomach. These operations can help reduce hunger and limit the body’s ability to absorb food. Bariatric surgeries have already been found to be effective for treating Type-2 diabetes, though most studies were done in people who are morbidly obese, with a body mass index (BMI) of 35 or above. BMI is considered normal between 18.5 and 24.9. A BMI of 25 or higher indicates that someone is overweight, and people with a BMI over 30 are considered obese.
Recently, a group of researchers from Taiwan's Min-Sheng General Hospital reported that weight loss surgery can help mildly obese people with Type-2 diabetes as well and the benefits can last for at least 5 years. It is, however, still too early to confirm if mildly obese people with diabetes live longer after weight loss surgery than those who receive non-surgical treatments. Their findings were published online September 16, 2015 in ‘JAMA Surgery’. In the study, the researchers examined data collected since 2007 in trial comparing 2 kinds of bariatric surgery, gastric bypass and sleeve gastrectomy, with medical treatments for Type-2 diabetes in people who were mildly obese. The average BMI among those who had surgery declined from 31 to 24.5 by the end of their 5th year in the study, and the BMI among those receiving non-surgical diabetes treatments stayed about the same at 29. Their findings found that diabetes resolved completely in 36 percent and partially in 28 percent of those who had surgery. In comparison, diabetes resolved completely in only 1 percent and partially in about 2 percent of the medically-treated group. The control of blood pressure, triglycerides, and bad cholesterol (LDL) were found to be generally better in the surgical group. Patients’ blood levels of hemoglobin A1c were also monitored. Hemoglobin A1c reflects blood sugar levels over time and is best kept below 7 percent. In the study, the average hemoglobin A1c level fell from about 9 percent to about 6 percent after surgery. For patients in the medically therapy group, it remained steady at about 8 percent. Meanwhile, the average outcomes with 2 types of surgery were compared. At the 5th year, compared to the sleeve gastrectomy group, the bypass surgery group had lost more weight (18.7 vs 14.2 kg), achieved bigger drops in BMI (7.4 vs 5.1) and in hemoglobin A1c (3.1 percent vs 2.1 percent) and were more likely to have complete diabetes remission (46.9 percent vs 16.7 percent). Nevertheless, the researchers stressed that the better glycemic control, as reflected by the improved hemoglobin A1c levels, did not actually cut the mortality rate at 5 years.
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