Can Bariatric Surgery Be A Cure For Type 2 Diabetes In Obese Patients?

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Author(s): 
Ryan H. Fitzgerald, DPM

   In patients with diabetes, there is a consensus that bariatric surgery should be reserved for those individuals with a BMI >35 kg/m2.29 In patients over 60 years or in children and adolescents, bariatric surgery is not recommended because long-term outcomes in these patient populations have not undergone extensive testing.

   Furthermore, there is evidence to suggest that those patients who present for surgery with a more recent onset of diabetes (less than five years) are more likely to demonstrate diabetes remission postoperatively.27

In Conclusion

   In recent years, there has been substantial research and literature that demonstrates that, in certain instances, patients suffering from type 2 diabetes can achieve full remission of their symptoms following bariatric surgery. A weakness thus far in these studies is that these results come from patients with diabetes who have undergone bariatric procedures primarily for other reasons.

   Does bariatric surgery provide the option of a cure for type 2 diabetes? Certainly, it can in certain patient groups. For younger patients with a relatively recent onset of diabetes and BMI over 35, the literature demonstrates that bariatric surgery can provide a significant treatment option.

   However, further studies are required before we can recommend these bariatric treatment modalities to patients as a primary method of managing their diabetes.

   As clinicians involved in the interdisciplinary management of patients with diabetes, it is incumbent that podiatric physicians be versed in all manner of developing treatment options that may be available to our patients.

   The current data on bariatric surgery is promising and further evidence-based trials may indeed prove this treatment is the cure that will save millions of limbs and lives.

Dr. Fitzgerald is an Associate of the American College of Foot and Ankle Surgeons. He practices at Hess Orthopaedics and Sports Medicine in Harrisonburg, Va.

Dr. Steinberg is an Assistant Professor in the Department of Plastic Surgery at the Georgetown University School of Medicine in Washington, D.C. Dr. Steinberg is a Fellow of the American College of Foot and Ankle Surgeons.

For further reading, see “Can A Gastric Bypass Procedure Have A Positive Impact On Diabetes?” in the July 2006 issue of Podiatry Today.




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