Bariatric surgery is a treatment option for obesity and diabetes in patients whose body mass index (BMI) is ≥ 35 kg/m2 and glucose levels aren’t controlled despite the best efforts with medications and lifestyle modification.
BMI is calculated as follows: BMI = weight (kg) ÷ height (m²).
Bariatric surgery has been a major advancement in treatment of people living with obesity and diabetes in recent years. Between 70 and 90% of these people will still be in diabetes remission two years post-surgery. Remission is defined as normal blood glucose on no diabetes medication for at least a year. Even 15 years after bariatric surgery, a third of people will still be in remission. Of those that need diabetes treatment again, simpler regimens achieve glucose control.
There are a variety of procedures available, and this should be individualised by the bariatric centre which will be staffed by a full multi-disciplinary team: surgeon, specialist physician, dietitian, psychologist, and exercise therapist.
The benefits extend beyond improving glycaemic control, as multiple other comorbidities (hypertension, sleep apnoea, high cholesterol) are also positively affected.
Bariatric surgery has few complications, but regular structured follow-up is essential. Particular attention must be paid to those complications relating to nutritional deficiencies since the stomach and intestines are responsible for absorbing nutrients from food eaten.
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