If you are extremely obese and have type 2 diabetes, weight-loss surgery may help you shed weight and reduce, or even reverse, type 2 diabetes. However, some patients see little or no improvement in their diabetes after surgery.
In the 2004 review of more than 130 studies, a University of Minnesota researcher and colleagues found that bariatric (weight loss) surgery caused obese people to lose 40.7% to 73.9% of their excess weight (depending on the procedure).
In patients who had type 2 diabetes, the diabetes was reversed completely in 77% of patients and reversed or improved in 86%.
However, the risks of such procedures are not insignificant (including a small risk of death), so it's important to discuss the risks and benefits and with your health-care provider before making such a life-altering decision.
And it's important to have presurgical counseling to explore the psychological reasons behind overeating; you have to change lifelong bad eating habits too.
Lisa Corbeil's story
When Lisa Corbeil had blood work in 2004 confirming type 2 diabetes, she had a "total meltdown" in her doctor's office. "I say that I went though all the stages of grief in about 20 minutes in her office," says Corbeil, an accounting professional in Philadelphia whose brother died of type 1 in 1995 at age 41. "Of all the things out there that I didn't want to get, it was this disease."
She underwent gastric bypass surgery in 2006 and dropped 155 pounds. The 47-year-old no longer has diabetes. "I have a life back. And I feel healthier now than when I was a thin 20-year-old," she says. "I'm kicking diabetes's ass."
However, her doctor still checks her hemoglobin A1C levels and Corbeil is careful about her exercise and food choices because she knows her diabetes could return.
"I always carry some protein bars and keep some protein drinks around just in case," she says. She no longer takes insulin or metformin. "It's just wonderful," she says.
Janice Rowe's story
Janice Rowe, 54, who lives in the Bronx, N.Y., was diagnosed with type 2 diabetes when she was 35. She had trouble controlling her blood sugar despite using a treadmill and trying multiple medications. "I was at my wit's end," she says.
Her father had died of complications from diabetes, so she was especially aware of the risks associated with the disease. "I always had the mind-set that I wanted to manage it," Rowe says. "But I just didn't know how."
In 2003 she had gastric bypass surgery and lost almost 100 pounds. But her blood sugar was still too high. "I still had a problem with diabetes," she says.
Her doctor put her on insulin in September 2007. "It scared the death out of me because I gained 10 or 15 pounds in just a couple of weeks," she says. (Insulin can sometimes cause weight gain.)
She credits her diabetes educator with turning her life around. When she first went to see her in October 2007, her blood sugar was 289 mg/dL, "and that was sort of average." Sometimes it was even higher. (A normal random blood sugar for a person without diabetes is 70 to 125 mg/dL.)
With her diabetes educator's help, Rowe fixated on three things: portion control, exercise, and medication. She quickly lost the weight she had gained while on insulin and reduced her blood sugar to 196 mg/dL with lifestyle changes.
Her diabetes educator also suggested that she try taking Januvia. Her doctor agreed, and soon after she began Januvia she was able to stop taking insulin and Byetta, which she had been taking since before her surgery.
She worked out six days a week and eventually her blood sugar dropped too low, prompting her doctor to adjust her medications. "So now my fasting blood sugar is usually around 110, but I sometimes become hypoglycemic in the morning," she says.
"It's a mind-set, and if you don't get the mind-set that you're going to deal with having diabetes, you're going to be in big trouble," she says.