Obesity and diabetes are related health conditions that pose significant challenges to individuals and healthcare professionals. However, recent research suggests that bariatric surgery, a weight loss procedure, may hold promise in treating complications associated with both obesity and diabetes. A study published in Diabetologia delves into the findings and implications of bariatric surgery’s effects on diabetes-related complications in individuals with obesity.1
What are the long-term complications of diabetes?1
Diabetes is a chronic condition intricately linked to the hormone insulin and affects the body’s ability to use glucose for energy. Without proper management, it can lead to various complications, such as peripheral neuropathy, retinopathy, and cardiac autonomic neuropathy.
- Peripheral neuropathy is nerve damage that can affect the feet, legs, arms, and hands, leading to a loss of sensation and, in some cases, pain.
- Retinopathy causes damage to the eyes and leads to vision problems.
- Cardiac autonomic neuropathy involves damage to the nerves that control the heart.
These complications can lead to poor health outcomes and a diminished quality of life.
How can bariatric surgery help people with obesity and diabetes?1
The prospective cohort study examined how bariatric surgery affected diabetes-related complications and metabolic risk factors in individuals with class 2 or 3 obesity. The study involved 79 participants who completed a 2-year follow-up after undergoing bariatric surgery. The results showed improvements in peripheral neuropathy, retinopathy, cardiac autonomic neuropathy stabilisation, quality of life, and pain management. Additionally, there were improvements in various metabolic risk factors, such as weight reduction and fasting glucose levels. Improvement in fasting glucose levels was associated with improvements in retinopathy, which shows that bariatric surgery may significantly impact diabetes complications.
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When is bariatric surgery recommended?1
Bariatric surgery aims to alleviate coexisting conditions, extend life expectancy, and improve quality of life. Individuals who struggle to lose weight through conventional methods like diet and medication, particularly those with type 2 diabetes and obesity, may consider bariatric surgery a recommended course of action. Various surgeries are available, including adjustable gastric banding, gastric bypass, and sleeve gastrectomy. Most insurance carriers accept a body mass index (BMI) greater than 40 or 35 with accompanying comorbid conditions like diabetes, hypertension, or sleep apnea as indications for bariatric surgery.
What are the limitations and future research directions?1
- While the research on bariatric surgery and diabetes complications provides valuable insights, there are some limitations to consider. These include a relatively small sample size, a lack of a control group, and challenges obtaining participant follow-up data.
- Additionally, the study’s brief follow-up time highlights the need for further investigation into bariatric surgery’s immediate and long-term effects.
- It is worth noting that the study mainly involved non-Hispanic women, which indicates the importance of including a more diverse range of participants in future research.
- Lastly, the study focused on specific evaluations of peripheral neuropathy, suggesting the possibility of conducting more comprehensive research in this field.
What cautions should be considered regarding the study’s results?1
- A board-certified physician, Dr Pate, cautioned that the study did not thoroughly evaluate the type of bariatric surgery performed. Therefore, it is difficult to determine whether the observed benefits were solely due to weight loss or specific surgical procedures. Further investigation is required to elucidate the optimal approaches to weight loss and their impact on diabetes-related complications.
- Study author and Associate Professor of Neurology, Dr Brian Callaghan, also shared ongoing research focusing on comparing the effects of exercise, bariatric surgery, or both on peripheral neuropathy, aiming to provide more robust data on the benefits of these interventions.
Conclusion
Bariatric surgery may offer a promising solution for individuals with obesity and diabetes. It may aid in weight loss and improve metabolic risk factors and quality of life. However, considering the study’s limitations, further research is needed to understand the long-term benefits and risks of bariatric surgery in this population. Seeking guidance from healthcare providers is crucial for individuals to assess if bariatric surgery is suitable for them.
As a medical professional, what are your thoughts on the safety and effectiveness of bariatric surgery for obese individuals with diabetes and complications? Please share below.
References
- Norris J. Bariatric surgery can treat complications in people with obesity and diabetes. [Cited: May 18, 2023]. Available from: https://www.medicalnewstoday.com/articles/bariatric-surgery-can-treat-complications-in-people-with-obesity-and-diabetes?fbclid=IwAR1IgzPx2AI-hPgIY2nVZrNG6olRSTRz9UVB4oSpBwTFR8Mlj5YI_WnmGDE
