About 90% of individuals with Type II Diabetes acquired the condition from excessive body fat associated with obesity. This is a condition where your body no longer utilizes insulin properly. This is a life changing condition that requires you to consistently manage blood sugar levels through diet, exercise and medication. \nBariatric surgery, commonly referred to as weight loss surgery, can be performed as a treatment for Type II Diabetes resulting in improvement and even remission. \nThis article will assist you in understanding how bariatric surgery works and if it is something you should consider to treat diabetes. \nWhat This Article Covers:\n\nHow Bariatric Surgery Works to Treat Diabetes\nTypes of Bariatric Surgeries\nWho Will Benefit?\nAssociated Risks\nPostoperative Outcomes\nChanges in Diet\nInsurance Matters\nCommon Misconceptions\n\nHow Bariatric Surgery Works to Treat Diabetes\nBariatric surgery aims to improve diabetes by lowering blood sugar levels, reducing medication dosing, and improving diabetic related health conditions. \nRemission of diabetes can occur if weight loss surgery reduces blood sugar to normal levels and also eliminates the need for diabetic medications. \nThese procedures involve surgery of the upper gastrointestinal tract and include shortening or altering parts of the stomach and\/or small intestine in order to restrict caloric intake and cause malabsorption of some nutrients. \nBariatric surgeries have also been seen to alter the secretion of certain hormones and gut microbiota which play a role in the regulation of glucose-control systems. \nAfter gastric bypass, food will bypass certain parts of the gastrointestinal tract and directly enter the small bowel. This can change gut function and production of hormones, which can then influence glucose regulation and blood sugar levels. \nImprovement or remission of diabetes can occur shortly after bariatric surgery and even before significant weight loss occurs due to the changes in gut hormones.\nThe anesthesia for bariatric surgery is relatively simple and low risk. Most patients who receive this surgery do well under general anesthesia. However, the anesthesiologist will consider any existing conditions before deciding the route of anesthesia before surgery. \nIt may be necessary to receive epidural anesthesia if local anesthesia is not suitable for an individual. \nTypes of Bariatric Surgeries\nRoux-en-Y Procedure\nMany different kinds of bariatric surgery procedures can be performed to treat diabetes. Although, the most commonly used is the Gastric Bypass procedure, also referred to as the Roux-en-Y procedure. \nRemission rates of type II diabetes is about 80% in gastric bypass patients. \n\nThis procedure reduces stomach volume by making a smaller stomach pouch to restrict caloric intake. This procedure also includes anatomical changes to the intestinal tract resulting in malabsorption of some nutrients resulting in significant weight loss. \nThe surgeon will cut the upper section of the stomach creating a small stomach pouch that is sealed off from the rest of the stomach. \nThen, part of the small intestine will be cut and attached to this smaller stomach section. \nIt is referred to as gastric bypass because the food you consume will flow into the smaller stomach that was created and continue directly into the intestine, skipping most of your stomach. \nGastric Band Surgery\n\nAnother intervention is the placement of a band around the top portion of the stomach that can be inflated to restrict the volume of food entering the stomach. \nThe silicon band can be inflated and deflated through a port that is placed under the skin of the upper body. The surgeon can then inflate the band by injecting a saline solution into the tube. \nThis has been shown to result in diabetic remission for at least 45% of patients. Improvement of diabetes comes secondary to weight loss in this procedure, so there is a lower rate of remission. Remission rates are lower since some individuals may be unsuccessful in losing an appropriate amount of weight after this procedure. \nGastric Sleeve Surgery\nThis procedure involves the removal of a majority of the stomach, creating a longer and thinner tube-like stomach. This will limit the amount of food that can be consumed in a given time. \n\nIt differs from a Roux-en-Y procedure in that there is no cutting and reattachment to any part of the small intestine. \nWith changes to the size of the stomach, there is still evidence of changes to gut hormones that can effect blood sugar control and diabetes, as well as weight loss benefits. \nRemission rates after gastric sleeve are similar to gastric bypass with about 60% remission. \nWho Will Benefit?\nPatients with type II diabetes who are moderate to morbidly obese would benefit the most from bariatric interventions. Bariatric surgery in children and adolescents is an option for those who suffer from obesity-related diabetes. \nThis is especially true for a patient who has tried non-surgical weight loss interventions without obtaining satisfactory results. \nAssociated Risks\nWhen considering bariatric surgery, it is clear that the benefits substantially outweigh the risks. \nComplications may vary based on the bariatric procedure performed. \nThe complications of bariatric surgery may include the following: \n\nGastrointestinal leakage\nBlood clots\nBowel obstructions resulting in constipation or internal hernias\nStricture\n\nEven with the possible complications, the long-term risk of continued obesity-related diseases, like type II diabetes, outweighs the surgical risk of bariatric surgery. Bariatric surgery can provide improvements in quality of life and obesity-related health conditions. \nWith increased medical technology and improved patient follow-ups, bariatric surgery has been deemed successful and safe for those looking for treatment of obesity-related diseases. \nPostoperative Outcomes \nWeight Loss\nThe most important outcome of any bariatric procedure is weight loss. Regular monitoring of weight loss, as well as BMI, will be important to assess progress in diabetes and obesity management. \nThe amount of weight loss will depend on the bariatric procedure and the adherence to lifestyle change after surgery. \nIn general, weight loss after bariatric surgery can range from 50 to 70 percent reduction in excess weight. These weight loss surgeries have also been associated with improvement in sleep apnea, which is commonly associated with obesity. \nInsulin Monitoring\n\nYou should continue at home insulin monitoring even after the operation is performed. \nOther Medical Conditions\nOther medical conditions that may need to be managed after bariatric surgeries will need to be considered. \nThis would include:\n\nAcid Reflux\nNausea\nVomiting\nHigh risk of vitamin and mineral deficiencies\n\nFollow-Ups\nRegular follow-ups with the surgeon or practitioner should be emphasized.\nFollow-ups should include an assessment of the healing progress and potential complications, including deficiencies. Weight loss progress will also need to be closely monitored to ensure that target goals are reached. \nDepending on the surgery performed, it may also be necessary to have follow-up surgeries after a month, 6 months, or a year. \nChanges in Diet\nOnce you have been discharged, you will likely be instructed to consume a liquid diet for a period of time. This liquid phase would include bariatric protein shakes and other full liquids that fit into this category. Then, you will slowly progress to soft foods and eventually solid foods. \nFood intake will be greatly reduced within the first 3 months, and therefore the glycemic load will also be reduced significantly. \nYou should also make sure that you are drinking enough fluids to prevent dehydration. \n\nOnce you are fully in remission, you are encouraged to consume well-balanced and nutritionally adequate meals, including a variety of vegetables, fruits, and protein. You must also consume smaller, and more frequent meals to help control blood glucose levels. \nThe slow consumption of food will prevent some GI complications, as well as prevent overconsumption that can eventually lead to weight regain.\nBariatric surgery is only a tool for weight loss. It does not guarantee long term weight loss. It is merely a step in the right direction, and lifestyle changes are imperative to keep weight off.\nIt is recommended to seek the advice from a clinical dietitian for the months following the procedure. \nInsurance Matters\nMost insurance providers do not cover cosmetic weight-loss surgeries. Although, depending on your current BMI, you may qualify for benefits.\nIf your BMI is over 35 and you have other weight-related conditions, or if your BMI is over 40, then your insurance provider will most likely cover bariatric procedures.\nIf you have a BMI of 35 or higher, without weight-related conditions, insurance may not cover bariatric procedures. In the case where non-surgical weight loss interventions have not been successful, insurance may cover the costs with proof of previous attempts at weight loss. \nCheck with your service provider on their terms to determine whether or not this surgery will be covered for you. \nCommon Misconceptions\n“It will leave a large scar” \nBariatric surgeries are relatively non-invasive and medical equipment is more advanced than in the past.\nSurgery is performed through a small incision, with minimal blood loss and scarring when compared to open surgeries. You can discuss any scarring concerns with your surgeon beforehand. \n“You cannot have children after bariatric surgeries”\nPregnancy should be avoided for at least 12-18 months after surgery or when deemed safe by your bariatric team and OBGYN. This should not affect your chances of becoming pregnant beyond this time frame. Weight loss surgery has actually been shown to increase fertility rate. \nIt is recommended that pregnancy be avoided due to rapid weight loss and potential micronutrient deficiencies that may follow after the procedure. \n“The recovery process is long and painful” \nThe average recovery period for these surgeries is between 3-4 weeks. With an increase in medical technologies, it is now safer than ever to have this surgery. Recovery time frame can be based on the individual and other medical conditions they may be managing.\nYou should be back to your normal day-to-day activities within 3 to 5 weeks. \nThere are a variety of bariatric surgery aids to help with recovery like gastric sleeve pillows. \n“This surgery will leave me with lots of loose hanging skin” \nThe main goal of this surgery is to initiate weight loss. If the weight loss is significant, the patient may be left with some excess skin. It is not unmanageable. \nChafing, rashes, and infection are a primary concern of excess skin, but this can be avoided by wearing clothes that don't rub against the skin. \nIt can also be minimized through exercise and a healthy skincare routine. Keeping the skin folds clean and dry will minimize your risk of infections and irritation. \nCosmetic surgery can also be considered for the removal of excess skin after bariatric surgery.\nDid you find our blog helpful? Then consider checking:\n\nBariatric Surgery\nBariatric Diet\nBariatric Cookbook\nGastric Bypass Surgery Cost\nGastric Bypass And Anemia\nGallbladder Problems After Gastric Bypass\nRecovery After Gastric Bypass Surgery\nWhat Pain Medication Can You Take After Gastric Bypass\nMultivitamins For Bariatric Patients\nHow To Tighten Loose Skin After Gastric Bypass Without Surgery\nTummy Tucks After Gastric Bypass\nGastric Bypass And Kidney Stones\nGallbladder And Gastric Bypass\nGastric Bypass Long Term Results\nBariatric Support Groups\n\n**This blog is for information and education purposes only. This information is not intended to substitute professional medical advice, diagnosis, or treatment. Please consult with your physician or another qualified health provider with any questions in regards to a medical condition.