Metabolic Surgery in Treating Diabetes
Metabolic surgery refers to a group of procedures that involve either reduction or bypassing sections of the stomach and small intestine, and are commonly used as a treatment for obesity. Metabolic surgery has been shown to dramatically improve glycemic control, leading to complete resolution of Type 2 Diabetes in the majority of patients, depending on the procedure, as well as lead to reduction of 47%-70% of excess weight, depending on the procedure.
Despite its suggested benefits this group of procedures comes with substantial risk and limitations. Most metabolic surgeries are only applicable to obese and morbidly obese patients (BMI>35 kg/m2). In addition, metabolic surgery is major abdominal surgery, even when minimally invasive surgical techniques are used. It is a complex, often irreversible procedure that has a significant anatomical effect. Patients considering metabolic surgeries must be ready to forever change their eating practices. After surgery, a liquid-only meal plan is required for two to three weeks. After three weeks the diet is usually advanced to soft foods for the next six to eight weeks with a gradual transition to regular consistency foods over the next six to nine months. In the long-term, significant eating-habit changes must be adopted to ensure the procedure’s success. Patients may need to indefinitely supplement their diet with vitamins and nutrients to overcome the substantial malabsorption caused by some of these procedures.