Some doctors are currently looking at weight loss surgery, such as gastric bypass surgery or stomach stapling for diabetes care, even if patients are only mildly obese or overweight. If proven completely safe and successful, this weight loss surgery technique used for diabetes management will take the place of the traditional insulin shots and other medications people use for diabetes control.
In recent years, scientists who have been studying gastric bypass surgery as form of diabetes management, have found that after the weight loss surgery, some obese patients did very well. These patients had normal blood sugar and did not need medications anymore.
However, other experts have questioned whether achieving normal blood sugar is enough to justify receiving this major weight management surgery. They do not have enough information yet to confirm that gastric bypass surgery or stapling of the stomach permanently controls blood sugar to the point that it reduces a person's risk of diabetes complications such as nerve, kidney and foot damage.
Serious surgery such as gastric bypass should be a last resort after traditional methods such as proper diet and exercise have failed to control weight loss for morbidly obese individuals. Even in these cases, there are strict rules and physical and psychological tests that are given to these patients before they can undergo this kind of surgery.
Federal guidelines say that those who are able to be considered for gastric bypass surgery must be at a body mass index (BMI) of over 40, which puts them in the morbidly obese category, or a BMI over 35 plus a weight-related medical problem like diabetes or high blood pressure. Insurance companies will often pay for the gastric bypass surgery in order to pay for this kind of surgery. The American Diabetes Association confers that there is currently not enough evidence of the success of the gastric bypass surgery to recommend it for diabetics with a BMI lower than 35 outside of a controlled, experimental laboratory.
One patient, a 45 year old mother of two, who was not obese, but bordering the condition opted to have the weight loss surgery despite not being of optimal weight to be the best candidate for this kind of serious surgery. She felt as though she hadn't any choice, but to try this form of diabetes management, as medications and insulin were not helping to control it. Her blood sugar was still way out of control. Although doctors know that they would be stretching the rules of weight loss surgery to perform gastric bypass or stomach stapling surgery on a patient who was not heavy enough to have it done, a doctor at New York Presbyterian/Weill Cornell Medical Center agreed to do the surgery for this woman. Her surgeon, Dr. Francesco Rubino, has been pleased with her progress so far, but stated, "It's important to tell patients this is a promising option, but of course we can't promise this is the cure for diabetes for everybody."
Despite the rules of weight loss surgery, this patient had the gastric bypass surgery this past fall and it proved very successful. Her stomach was reduced to a thumb-sized pouch that now holds less food. She is now fifty pounds lighter and her blood sugar is almost completely normal without taking any medications. She stated, "I didn't care if I lost any weight. I just wanted the diabetes to go away,"
Dr. Philip Schauer of the Cleveland Clinic is one such doctor who will consider doing gastric bypass surgery as a weight management technique on people who do not meet the federal guidelines of being of a high enough weight for the surgery. He is currently conducting a study to see if the outcomes back up his decision to be one of a few doctors in the country who will perform the surgery under risky conditions. Dr. Schauer stated, "These procedures can cause long-term remission and restore someone to normal blood sugar levels without medication."
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