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Type 2 Diabetes: Why Bariatric Surgery Is Safer Option

Bariatric SurgeryDoctors typically consider bariatric surgery for those with a body mass index (BMI) above 40. But a recent study by Cleveland Clinic physicians suggests the threshold can be lower if you have type 2 diabetes.

It’s a good idea to consider having surgery to help you lose weight if you have diabetes and your BMI is higher than 30, says surgeon Ali Aminian, MD, one of the study’s authors.

Bariatric surgery may help reduce your blood sugar levels over the long term, he says.

Hospitals set the guidelines decades ago when open surgery was the only option for a bariatric procedure. Now that doctors can perform the surgery through small incisions, it’s safer, Dr. Aminian says.

“We have high-quality data in patients with lower BMIs with diabetes that shows it would be a safe and very effective intervention for them,” he says.

What were the study’s findings?
Cleveland Clinic physicians analyzed 252 patients who had surgery at the hospital from 2004 to 2012. Most were overweight or obese, had high HbA1c levels and had diabetes for about a decade. All patients were taking insulin before surgery.

Three-quarters of the patients had gastric bypass surgery. The rest had a sleeve gastrectomy, where the stomach is dramatically reduced in size.

Doctors followed up with the surgical patients five to 12 years later and found:

  • 44 percent had long-term glycemic control without insulin.

  • 59 percent met the American Diabetes Association glycemic target (HbA1c less than 7 percent).

  • 15 percent had achieved remission.

  • The patients also lowered their BMI, blood pressure and cholesterol levels.

How does early intervention help?