A study in patients who had bariatric surgery to treat diabetes, many of which had the Gastric Bypass Roux-en-Y, over 78% of those patients experienced remission in their Type 2 Diabetes, thus eliminating the need for treating medications.1 Not only do bariatric patients see improvements with diabetes, but also with obesity and many associated co-morbidities.
Type 2 Diabetes affects more than 34 million U.S. adults.2 It can lead to Cardiovascular Disease (CVD), which is the number one cause of death in people living with diabetes, resulting in 2/3 of deaths.3 It can also lead to Chronic Kidney Disease, hearing loss, high blood pressure, neuropathy, and stroke. Studies have shown that patients that have undergone bariatric surgery had fewer heart attacks, strokes, kidney failure, and heart failure.4
So What is Diabetes (Type 2)?
Type 2 Diabetes Mellitus (T2DM), the most common form of diabetes, is when the body becomes resistant to insulin (a hormone that controls the blood sugar levels in the body). The cause of Type 2 Diabetes in 90% of those diagnosed has been attributed to obesity (medically defined as a body mass index (BMI) of 30 kg/m or more.) Excessive body fat has been identified as one of the largest causes of developing Type 2 Diabetes. This disease can unfortunately lead to many health problems and co-morbidities such as heart disease, stroke, blindness, kidney failure, amputations, high blood pressure, psychiatric disorders, and an increase in risk for certain forms of cancer.
Type 2 Diabetes can often worsen overtime, which is why it is considered to be a chronic and progressive disease, leading to even more medication or increases in dosage to keep blood sugar levels stable. It has become one of the most expensive chronic diseases in the US.5 In 2017, the cost was $327 billion dollars with 1 in 4 healthcare dollars attributed to diabetes averaging medical expenditures of about $9,600 per year, 2.3 times higher than non-diabetics.6 It is estimated by The Centers of Disease Control and Prevention (CDC) that 34.2 million people of all ages had diabetes and 7.3 million adults aged 18 years or older were not aware of or did not report having diabetes (undiagnosed).7 The percentage of adults aged 18 years or older increased with age, reaching 26.8% among those aged 65 years or older.
How Bariatric Surgery Can Help
Weight loss is important in managing diabetes. Not only can bariatric surgery result in weight loss, but glycemic control is restored by a combination of enforced caloric restriction, enhanced insulin sensitivity, and increased insulin secretion.8 According to our own bariatric surgeon, Dr. Steven C. Simper, MD, FACS, we aren’t entirely certain why one procedure would better benefit than another, or have a concrete answer as to why it helps. “It is, however,” Dr. Simper says, “crystal clear that is does cause diabetes to go away in most patients with Type 2 Diabetes, and has significant benefits, even in patients whose diabetes doesn’t go away, including Type 1 Diabetes.”
Who is a Candidate for Bariatric Surgery?
If your health insurance plan does cover surgery, they will require certain steps and documentation in order to issue an authorization; we refer to these requirements as criteria. The criteria will vary from insurance company to insurance company and even sometimes from employer group to employer group. Your friend’s requirements and timeline to surgery may be very different from yours depending on those criteria.
All insurances will require you to have a diagnosis of morbid obesity. This is shown by a BMI (Body Mass Index) of ≥40, though if you have a co-morbid condition such as Type 2 Diabetes, Obstructive Sleep Apnea or High Blood Pressure, your BMI can be as low as 35.
Though all other criteria will vary, most commonly we see the insurances require a specific length supervised diet program, a one-time visit with a nutritionist for an evaluation and/or a psychological assessment. Additionally, you may be required to get some labs drawn, prove morbid obesity for a number of years or obtain a letter from your Primary Care Provider clearing you for surgery. The idea behind this criterion is to make sure you are prepared emotionally and physically for the changes that surgery will require and to help ease the transition to your new post-operative lifestyle.
If you are planning on paying cash for your surgery at St. Mark’s Hospital, instead of using insurance coverage, you will only have to complete a psychological evaluation. This is St. Mark’s Hospital policy as part of their Center of Excellence standing with MBSAQIP.
At RMAP, we believe that patients should choose their bariatric surgery after receiving quality education about the benefits and risks of each procedure. We strive to provide you with up-to-date and evidence-based information about each surgery to help you with that decision.
If you are interested in learning more about each of the procedures, the benefits and risks of each of them, and what procedure is best for you, we invite you to attend our free informational seminar.
Links to similar articles:
Weight Loss Surgery and Diabetes: How Does it Resolve?
Weight Loss Surgery and the Insurance Process
Bariatric Surgery as a Benefit of Diabetes
www.RMAP.com
Rocky Mountain Associated Physicians
801-268-3800
1160 East 3900 South, Suite 4100
SLC, UT 84124
- https://asmbs.org/patients/surgery-for-diabetes (American Society for Metabolic and Bariatric Surgery (ASMBS))
- https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf (The Centers of Disease Control and Prevention (CDC))
- https://diabetes.org/diabetes/cardiovascular-disease (American Diabetes Associated (ADA))
- https://www.cbsnews.com/news/study-finds-weight-loss-surgery-decreases-risk-of-heart-attack-and-stroke/ (CBS News)
- https://diabetesjournals.org/care/article/41/5/917/36518/Economic-Costs-of-Diabetes-in-the-U-S-in-2017 (American Diabetes Associated (ADA))
- https://www.diabetes.org/about-us/statistics/cost-diabetes (American Diabetes Associated (ADA))
- https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf (The Centers of Disease Control and Prevention (CDC))
- https://ncbi.nlm.nih.gov/pmc/articles/PMC3102524/ (National Library of Medicine (NIH))