What is Metabolic Surgery for Diabetes?

Posted on: 31st Mar, 2023


When people think of treating or managing type 2 diabetes, medications are typically what come to mind. But the most effective treatment for type 2 diabetes isn’t a drug or even diet and exercise—it’s actually a surgery. So, what is metabolic surgery for diabetes?

The Benefits of Surgery for Type 2 Diabetes Management

Surgery as a method of managing diabetes may sound odd, particularly for people who think of type 2 diabetes as a condition that we treat with medications including shots and pills, as well as diet and exercise. Basically, the goal has been to control the blood sugar number and keep it in a reasonable range. If it stays elevated over long periods of time, there is increased damage done to the organs, especially the eyes, kidneys, and small blood vessels of the heart, brain, feet and lower legs. So the theory had been to keep the blood sugar number in check, and all should be well.

But it turns out that controlling the blood sugar number is not enough. Studies in the 2000s and 2010s showed that even with good numbers, the diabetes still caused major health problems. That reality led scientists and diabetes doctors to take a harder look at metabolic surgery, which had this habit of causing a full remission of diabetes for many of those undergoing a procedure.

Surgery upended the “control the number” thinking by directly changing the tissues and therefore the key hormones in the bloodstream at a root cause level. We’ve learned that diabetes is caused by a failure of blood sugar regulation at many levels in the body. Specifically, the tissues have a difficult time utilizing and absorbing the blood sugar, which is the phenomenon known as insulin resistance. Insulin resistance can occur for a bunch of reasons, including our genetics and body weight that influence key hormone levels and regulating how the tissues use insulin and blood sugar. Surgery improves the profile of the key hormones by making specific changes in the tissues where the hormones are produced, namely, the stomach and the small intestine. It may seem strange that the key to regulating type 2 diabetes stems from hormone levels that are coming from stomach and intestinal tissues—and that’s exactly what the original doctors thought also when they were first discovering this phenomenon among diabetic patients recovering from stomach surgery.

Now, 75 years later, scientists have narrowed down the hormone family to around two dozen key hormones that play a role in regulating blood sugar. It has allowed the surgical community to more narrowly target the gastrointestinal tissues, and make smaller, simpler, and safer interventions like sleeve gastrectomy, which reduces risk and eliminates side effects while still delivering impactful improvement of the type 2 diabetes.

According to the Research

Over a dozen randomized controlled trials, published over the last 20 years have shown that surgical interventions, including sleeve gastrectomy or gastric bypass, result in far superior treatment of type 2 diabetes than conventional treatments with the modern array of medications paired with even intensive diet and exercise.

Metabolic surgery remains intertwined with weight-loss surgery, just as the hormone families that regulate body weight are intertwined with the hormone family that regulates blood sugar. The two are not quite identical, but they share a lot of similarities. Metabolic surgery refers specifically to these hormonal changes improving metabolism, fat storage, circulating triglycerides, and, of course blood sugar. Most people experience a full remission of their type 2 diabetes after undergoing metabolic surgery, a procedure which is today considered to have a quite safe profile, along the lines of that of common procedures, such as appendectomy or cesarean section.

Ready to learn more? The team at Nevada Surgical is here to answer all of your question about metabolic surgery as a treatment for type 2 diabetes. Contact us today to get started.

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