As part of National Diabetes Week (11th – 17th July 2021), Weight Loss Solutions Australia will be shining a spotlight on Type 2 Diabetes and the effectiveness of bariatric surgery as a treatment option.   

According to the Australian Bureau of Statistics, almost 1 million Australian adults have diabetes. This number is likely to underestimate the prevalence of Type 2 diabetes as many cases remain unreported and undiagnosed. 

The impact of Type 2 diabetes is huge and is associated with a myriad of complications that affect the feet, eyes, kidneys, and cardiovascular health. Cardiovascular disease (CVD) is the primary cause of death, with around 65% of all CVD deaths in Australia occurring in people with diabetes or pre-diabetes. 

While there is currently no cure for Type 2 diabetes, the condition can be managed through lifestyle modifications and medication. Effectively managing diabetes is the best way to prevent diabetes-related complications. Evidence, including large-scale randomised control trials, shows Type 2 diabetes can be prevented or delayed in up to 58 percent of cases by maintaining a healthy weight, being physically active and following a healthy eating plan. With weight management being the most effective way to manage Type 2 diabetes, bariatric surgery is a very real avenue for not only the treatment of diabetes but diabetes remission. 

Diabetes Australia, the national body for diabetes describes in their position statement, “Bariatric surgery is increasingly recommended as a treatment for obesity and for people with obesity-related medical conditions.” They continue, “In those who are very obese, weight loss is not easily achieved or maintained by dietary changes and exercise alone and bariatric surgery has been shown to be a more successful intervention for long term weight loss.”

Diabetes Australia notes that most people with Type 2 diabetes experienced improved blood glucose levels after bariatric surgery, which for some will return to normal without the need for medication. 

Dr Ahmed Aly, one of Australia’s upper gastrointestinal surgeons explains, “There are very high rates of long-term remission following bariatric surgery if you catch diabetes in the first five years”. Dr Aly recalls a patient of his who had Type 2 diabetes and had been on high levels of insulin a day for the past 12 months. This patient came back to see him six months after bariatric surgery and was off all his insulin and blood glucose levels within perfect ranges. He recalls thinking, you’re essentially ‘cured’ of diabetes.

According to Reuters Health, a Danish study found that three in four obese people with Type 2 diabetes who had bariatric surgery (Roux-en-Y gastric bypass, in particular, one of the more powerful surgeries) experienced remission of their diabetes within a year after surgery. 

It has been over 10 years since the resolution of Type 2 diabetes was observed as an additional outcome of the surgical treatment of obesity. Diabetes-related morbidity and mortality have declined significantly postoperatively, and this improvement in diabetes control is long-lasting, according to the study. 

While there is no “cure” for Type 2 Diabetes, it is evident that bariatric surgery as a treatment option for Type 2 diabetes has very real, long-term benefits.  

Written by
Bayleigh Witheriff,
WLSA Dietitian 

References:

1. Australian Bureau of Statistics (2018), ‘Diabetes: Key Statistics and information about diabetes and its prevalence in Australia’, < https://www.abs.gov.au/statistics/health/health-conditions-and-risks/diabetes/latest-release>
2. Diabetes Australia (2011), ‘National Position Statement: Weight Loss Surgery (Bariatric Surgery) and its Use in Treating Obesity or Treating and Preventing Diabetes’, < https://www.diabetesaustralia.com.au/wp-content/uploads/Position-statement-Bariatric-Surgery.pdf>
3. Diabetes Australia (2021), ‘About Diabetes: Type 2 Diabetes’, < https://www.diabetesaustralia.com.au/about-diabetes/type-2-diabetes/>
4. ISSUU, published by Winter Circle (2021), ‘Dr Ahmad Aly Discusses Type 2’, < https://issuu.com/circle4/docs/nsw_circle_winter_2021/s/12471248>
5. Reuters Health (2018), Lisa Rapaport, ‘Gastric Bypass Surgery Tied to Diabetes Remission’, < https://www.reuters.com/article/us-health-obesity-diabetes-idUSKCN1QI5LT>