June 7, 2016

Bariatric Surgery Now Recommended For Many Type 2's

Do we need these guidelines giving surgeons the right to do surgery when the patients don't want it?  You will have to think fast to avoid this surgery.  These surgeons must be so desperate for money they are trying anything to bring in the dollars.

The new clinical guidelines were published May 24, 2016. The sad part is that they are endorsed by leading international diabetes organizations, including the International Diabetes Federation (IDF). The guidelines call for bariatric surgery, involving the manipulation of the stomach or intestine and this is to be considered a standard treatment for type 2 diabetes.

The guidelines, published in Diabetes Care, recommend surgery to induce weight-loss for certain categories of people living with type 2 diabetes, which accounts for the majority of the estimated 415 million cases of diabetes worldwide. The recommendation is based on evidence from multiple clinical trials that bariatric surgery can improve blood glucose levels more effectively than lifestyle or pharmaceutical interventions in obese people with type 2 diabetes.

What few of the studies addressed are the nutritional problems caused by bariatric surgery. Another missed topic is the percent of bariatric surgeries that are undone by patients overeating and stretching the stomach. These are two of the serious problems created by bariatric surgery, which are seldom addressed until too late. This often causes serious health problems for the surgery patient as I talked about in this blog on vitamin D deficiency.

While being overweight and obesity are major risk factors for type 2 diabetes, many of these people don't develop type 2 diabetes and I fear that many will be bullied into surgery with the nutritional problems becoming worse for people under going bariatric surgery.

At least the authors admit there are risks of complications and long-term nutritional deficiencies that require rigorous long-term follow-up by expert teams. The IDF estimated that in 2015 over $670 billion was spent globally to treat diabetes and prevent complications. Despite this, less than 50% of people with type 2 diabetes currently achieve the appropriate blood glucose levels to avoid or reduce the risk of long-term complications.

The new guidelines, which emerged from the Second Diabetes Surgery Summit (DSS-II) held in London in September 2015 as a collaboration between IDF, Diabetes UK, American Diabetes Association, Chinese Diabetes Society and Diabetes India, recommend bariatric surgery for people with type 2 diabetes who have a BMI of 40 and those with a BMI of 30 who are not able to adequately control their blood glucose levels through other means. This threshold is lower for people of Asian descent.

This is the first time that guidelines recommend surgery as a specific treatment option for type 2 diabetes.  Also read this article which they label as metabolic surgery.  This is becoming the hot topic in most medical sources and WebMD has an article about weight loss surgery for people with type 2 diabetes.


Denise said...

I understand that, in the short term, if you're only considering the blood sugar management implications of the life-altering, permanently disfiguring surgery being espoused, there is an argument to be made that this is a valid form of "treatment" for Type 2 diabetes, but to put it forward in place of food, exercise, and stress management is infuriating. The quality of life for someone who cannot eat more than a few ounces of food at a time, never with a beverage, and never, ever drink even the smallest amount of alcohol again must be weighed against the possibility of proper management with other, less drastic treatment options.

Bob Fenton said...

Thanks Denise! You are right about the few ounces of food. Two people I know have had this surgery and both are very sorry they did. While they lost weight and the one that did have type 2 diabetes was able to stop all medications in the year following surgery, now eight years later, she has to take insulin and still has a difficult time managing her blood glucose level. The other person, now ten years after surgery, weighs more than he ever did and has needed several surgeries to repair his stomach from the stretching it took and the perforations that happened.

Both have been prescribed special multivitamins as they have been found deficient in many and need to take mega-doses of many vitamins and minerals. Both need to have vitamin B complex shots on a weekly basis and are still barely above the deficient mark. They have more health problems now than before surgery and both wish they had been properly counseled before the surgery. Both feel that they were rushed into surgery without the knowledge of possible side effects they now know exist.