Controversial Topic: Bariatric Surgery - A Cure for Type 2 Diabetes?

Is Bariatric Surgery Really the Answer?

The incidence of type 2 diabetes continues to increase worldwide with no immediate remedy on the horizon.  Addressing or alleviating some of the potential risk factors for type 2 diabetes has become the prevailing strategy for combating this ever-increasing epidemic.  Overweight and obesity is one of the leading risk factors for type 2 diabetes, and along with diet and exercise it is one of the most common risk factors targeted for delaying onset or controlling the disease in those diagnosed (American Diabetes Association, 2012).  Since 90% of all diabetics are overweight or obese, this is clearly an area of great concern.  Bariatric surgeries to facilitate weight loss, such as gastric bypass, laproscopic adjustable gastric banding (lap band), and gastric sleeve surgery, are now being proposed as a means of curing or resolving type 2 diabetes prevalence (Science Daily, 2009). 

Evidence reveals that diabetes does go away for some people following gastric bypass surgery, in some cases even before significant weight loss (Science Daily, 2012).  Is this a lasting effect and does it mean that the individual has been cured of type 2 diabetes?  Buchwald et al. (2009) established that clinical and laboratory manifestations of type 2 diabetes are resolved or improved in the majority of patients following bariatric surgery, but there was no indication of long lasting effects.  In fact, a recent study revealed that "although gastric bypass surgery reverses type 2 diabetes in a large percentage of obese patients, the disease recurs in about 21% of them within 3-5 years" (Science Daily, 2012, para. 1), which indicates that the long-term effects of the procedure are questionable at best. 

Although there is an established link between weight loss and diabetes management, does it mean that we have reached a point where drastic measures are seen as the only solution? Comparing the cost of bariatric surgery with long-term diabetes care might lead many to support bariatric surgery as a legitimate way to reduce type 2 diabetes prevalence, but one must also consider if that would be merely trading one problem for another?  According to  Arterburn et al. (2012), improvements in risk factor reduction and lifestyle changes in diabetics have not lowered the most significant diabetes-related outcomes: heart attacks, strokes, and deaths.  This leaves us to ponder the following question:  What is the real solution to the type 2 diabetes epidemic?

References

American Diabetes Association (2012). Your risk: Who is at greater risk for type 2 diabetes? Retrieved from http://www.diabetes.org/diabetes-basics/prevention/risk-factors/

Arterburn, D. E., Bogar, A., Sherwood, S. S., Coleman, K. J., Haneuse, S., O'Connor, P. J. ...Selby, J. (2012). A multisite study of long-term remission and relapse of type 2 diabetes mellitus following gastric bypass. Obesity Surgery. doi:10.1007/s11695-012-0802-1

Buchwald, H., Estok, R., Fahrback, K., Banel, D., Jensen, M. D., Pories, W. J., & Sledge, I. (2009). Weight and type 2 diabetes after bariatric surgery: Systematic review and meta-analysis. The American Journal of Medicine, 122(3), 248-256.e5. doi:10.1016/j.amjmed.2008.09.041

Science Daily (2009). Potential for resolving type 2 diabetes with bariatric surgery. Retrieved from http://www.sciencedaily.com/releases/2009/03/090303082809.htm

Science Daily (2012). Gastric bypass surgery helps diabetes but doesn't cure it, study suggests. Retrieved from http://www.sciencedaily.com/releases/2012/11/121126142957.htm

World Diabetes Day

Diabetes is recognized as a dangerous epidemic affecting populations in significant numbers, both here in the U.S. and abroad.  In order to truly combat this rising global health problem, worldwide awarenss measures are among the primary tools utilized.  Wednesday, November 14, is World Diabetes Day (World Health Organization [WHO], 2012).  There are an estimated 346 million people worldwide with diabetes and this number is expected to double by the year 2030, without effective education and intervention strategies (WHO, 2012).  The World Diabetes Day awareness campaign outlines the ever-increasing international rates of diabetes, the economic impact of diabetes, and describes ways to prevent diabetes-related complications.  There are numerous resources available to facilitate diabetes awareness in your area on World Diabetes Day.  Materials include:

• posters
• campaign booklets that provide an overview of the campaign
• day booklets expressing the campaign theme
• promotional items (bracelets, flags, pins, t-shirts, waist measuring tape)
• videos promoting the World Diabetes Day message
• online resources for assessing type 2 diabetes risk, glycemic control, and healthy food choices (International Diabetes Federation, 2011)

The sheer number of people with type 2 diabetes means that eventually each one of us will have someone we know and love affected by this health condition.  It is important that we arm ourselves with the information and resources necessary to help reduce type 2 diabetes prevalence.  Acknowleding and participating in World Diabetes Day is one way of doing just that.

References

International Diabetes Federation (2011). Diabetes: Protect our future. Retrieved from http://www.idf.org/worlddiabetesday/

World Health Organization (2012). World Diabetes Day. Retrieved from http://www.who.int/mediacentre/events/annual/world_diabetes_day/en/index.html