Bariatric surgery for obesity and diabetes helps control blood sugar

There are as many as 1.5 million diabetes patients in Taiwan, and many patients suffer from cardiovascular diseases caused by obesity and need to take lifelong medication. Statistics from the Shuanghe Hospital found that for people with diabetes and obesity, if drug treatment is ineffective, they can undergo surgery within three years to effectively control their blood sugar and get rid of the pain of long-term medication.

For patients with type 2 diabetes, weight loss surgery due to obesity can effectively lower their blood sugar, and patients can even get rid of the worry of taking lifelong medication.

Dr. Su Yanhao, a general surgeon at Shuang He Hospital, pointed out that from the end of November last year to date, a total of 80 patients with morbid obesity (body mass index BMI>35) have been admitted, of whom 33 had high blood sugar before the operation or had been diagnosed with diabetes and underwent weight loss surgery. Except for 4 patients who underwent gastric bypass surgery due to severe morbid obesity (BMI>40), the rest underwent sleeve gastrectomy.

The results showed that no matter what type of surgery was performed, one month after the surgery, the patient's fasting blood sugar and glycosylated hemoglobin had dropped significantly and were within normal values. Three months after surgery, nearly 70% of patients were able to stop taking medication.

In the outpatient clinic, a 44-year-old Mr. Li, who originally weighed 113.3 kg, was diagnosed with diabetes more than a year ago, but the medication control was not ideal. He was very worried that if the disease was not well controlled, he might have to face dialysis in the future. After evaluation, he decided to undergo weight loss surgery. Six months after gastric bypass surgery, the patient's weight dropped to 88.9 kg. One month after the operation, Mr. Li stopped taking diabetes medication.

Another case, Mr. Wu, 44 years old, originally weighed 128 kg and was diagnosed with diabetes. However, due to irregular medication and poor blood sugar control, he underwent sleeve gastrectomy after evaluation by a doctor. The patient said frankly that before the operation, the examination reports were all red, but now, the examination data are all normal. In order to maintain his health, he began to pay attention to his diet, and his body became lighter. He would go cycling whenever he had time.

Dr. Su Yanhao emphasized that last year the American Diabetes Association included bariatric surgery as one of the treatments for diabetes; this year, a study in the New England Journal of Medicine also pointed out that only bariatric surgery can significantly lower blood sugar and glycosylated hemoglobin, and reduce the BMI index.

Obesity is one of the important risk factors for diabetes. Diabetes is closely related to fat cells and intestinal hormones. As the duration of diabetes progresses, the function of the pancreas will gradually be lost. It is generally recommended that people who are diagnosed with diabetes and have morbid obesity should undergo surgery within 3 years. This can help retain more pancreatic function and give them a chance to cure diabetes.

◎Small Dictionary◎

Sleeve gastrectomy : Sleeve gastrectomy is a procedure that uses laparoscopic surgery and an automatic gastrointestinal stapler to create a small tubular stomach with a capacity of about 100cc. By reducing the volume of the stomach, the patient's food intake is reduced, and because the fundus of the stomach (which secretes appetite-stimulating hormones) is removed at the same time, the patient's appetite can also be reduced.

Gastrointestinal bypass surgery : Using laparoscopic surgery and an automatic gastrointestinal stapler, a small stomach pouch is reconstructed in the stomach. The length of the small intestinal bypass is then adjusted according to the patient's BMI, limiting the patient's food intake and reducing the effect of nutrient absorption in the small intestine.