Guidelines recommend weight loss surgery for diabetes

If you live with type 2 diabetes, especially if you are obese, updated guidelines came out in 2016 calling for weight loss surgery to become a more routine treatment option for your diabetes.

This is the first time bariatric surgery is recommended specifically as a diabetes treatment. Before, people considered bariatric surgery as an obesity treatment that only had the extra benefit of helping control diabetes.

The recommendations were endorsed by the American Diabetes Association and more than 40 other health groups.

And, it makes sense. Type 2 diabetes and obesity can be a deadly combination, and many studies have shown weight loss surgery can drastically improve diabetes.

These studies show that most obese diabetics who undergo weight loss surgery see their blood sugar levels dramatically improve. This is something I’ve seen with my patients, too. Some even no longer require medication to maintain normal blood sugar levels.

People can control diabetes with diet, exercise, medication or insulin. But those who struggle to control the disease could face heart disease, kidney disease or stroke. Some may risk limb amputation or sight loss.

The updated guidelines conclude the surgery should be a regularly considered option for certain patients with diabetes. It’s about better blood sugar control instead of pounds lost.

Instead of bariatric surgery, the procedure is called metabolic surgery when performed for diabetes. If you have a body mass index, or BMI, of 40 or greater, weight loss surgery is recommended regardless of your blood sugar level. If you have a BMI of at least 35 and have tried lifestyle changes and medication to control your diabetes with no success, the surgery is also recommended.

Weight loss surgery may also offer other benefits for diabetics. The surgery affects hormones, gut bacteria and other substances that may change how the body handles insulin and blood sugar.

Medicare often pays for certain types of weight loss surgery for people who are obese with an illness, like diabetes. Although rules vary, some insurance companies cover the surgery, too. Perhaps with these updated guidelines, insurance companies will expand coverage.

The surgery is not a cure for diabetes, since some people relapse. However, many people do remain in remission for years. It’s important for those struggling with obesity and diabetes to know weight loss surgery is an important treatment option.

To learn more about weight loss surgery, attend a free seminar at Anne Arundel Medical Center. To learn more or register, visit

By Alex Gandsas, MD, a bariatric surgeon and director of AAMC’s Weight Loss and Metabolic Surgery Program. To reach his practice, call 443-924-2900.
Originally published Jan. 30, 2017. Last updated Nov. 28, 2018.

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