Luis Hernandez, 52 of Lake Grove knows firsthand how bariatric surgery can lead to more than just weight loss. He was a diabetic and weighed just under 300 pounds with a body mass index (BMI) of 41. A person with a BMI greater than 40 is considered to be morbidly obese. He also suffered from high blood pressure and sleep apnea, using a breathing machine at night to help him sleep. "I was struggling with diabetes and taking 12 pills a day and two injections daily to control my sugar levels,” he said.
In 2007, he decided to have gastric bypass surgery with Dr. Arif Ahmad of Mather Hospital’s Bariatric Surgery Center of Excellence. Following his surgery, Hernandez no longer needed his diabetes medication. His blood pressure levels dropped and his sleep apnea disappeared. Today, he maintains a weight of about 204. "My life is completely different. I can walk and exercise. My knees don’t take the beating they used to from all the weight,” he said. "I’m free of medications to control my blood sugar now.”
Mr. Hernadez’ experience is not unique.
Bariatric surgery has been found to work better for treating Type 2 diabetes in some patients than standard medical therapies alone, and can also help to prevent the onset of the disease, according to recent studies.
While doctors and weight loss surgery patients have long noticed that weight loss surgery often led to a complete remission of the disease or a reduction in the amount of medication needed to control blood sugar levels, two studies published by the New England Journal of Medicine earlier this year were the first to compare medical treatment with bariatric surgery as a means of controlling Type 2 diabetes. In these studies, intensive medical therapy combined with bariatric surgery eliminated Type 2 diabetes or decreased the need for drugs to lower blood sugar levels more than with medical therapy alone.
A third study of extremely overweight people likely to develop Type 2 diabetes, also published this year in the New England Journal of Medicine, found that bariatric surgery not only produced sustained weight loss but substantially reduced their risk of developing the disease.
Mike Wooley of Rocky Point, 50, had gastric bypass surgery 2 ½ years ago and is also a patient of Dr. Ahmad. Prior to the operation, he weighed 325 pounds with a BMI of 43. While not a diabetic at the time, "I was on my way,” he said. "My doctors were saying I was pre-diabetic. My sugar levels were creeping up higher. My blood pressure was high. I was having trouble getting around. I started to feel somewhat depressed. All the things that come with being overweight… I think I had sleep apnea also. It was one thing after another.”
Today, he maintains a weight of 195-200, his blood sugar levels are normal, his cholesterol levels are down to about 200 from 265, and his sleep apnea has disappeared. "I just decided I was going to change. I did so by reading and learning and going to Dr. Ahmad’s seminars and talking to my family and going on the Internet,” he said. "For me it was a positive experience.”
Type 2 diabetes is the most common form of diabetes. According to the American Diabetes Association, millions of Americans have been diagnosed with type 2 diabetes and many more are unaware they are at high risk. The disease results when either the body does not produce enough insulin or the cells ignore the insulin. Insulin is necessary for the body to be able to use glucose for energy. An editorial in the New England Journal of Medicine that accompanied the report on the two studies noted that, "Type 2 diabetes is one of the fastest growing epidemics in human history.”
One of the studies was conducted in Rome among 60 patients ages 30 to 60 with a Body Mass Index (BMI) of 35 or higher. They were selected to receive one of two bariatric weight loss surgeries – gastric bypass or biliopancreatic diversion, both of which shrink the stomach and alter the small intestine. Those with the bypass operation had a 75 remission rate and those with biliopancreatic diversion – a more extreme operation – had a 95 percent remission rate.
The second study at the Cleveland Clinic involved 150 patients ages 20 to 60 with BMIs ranging from 27 to 43. These patients underwent gastric bypass or sleeve gastrectomy, which removes part of the stomach, shrinking its size. Remission rates from the Type 2 diabetes were 42 percent for gastric bypass and 37 percent for the gastrectomy.
The third study is the first large study to demonstrate the preventative effects of bariatric surgery on people are morbidly obese and likely to develop the disease. Over a period of 15 years, patients who underwent one of three types of bariatric surgery were 80 percent less likely to develop the disease than people who tried losing with through diet and exercise under their doctor’s supervision. Those with highest blood sugar levels at the start of the study reduced their risk of developing Type 2 diabetes by 90 percent.
"Bariatric surgery is successful not only in helping morbidly obese individuals regain their life by giving them a tool to help achieve significant weight loss but also in fighting diabetes,” said Arif Ahmad, MD, Director of Mather Hospital’s Bariatric Surgery Center of Excellence. "I have had many patients experience remission from Type 2 diabetes after surgery. I have also seen patients with very high blood sugar who were on their way to becoming diabetic experience a significant lowering of those blood sugar levels following bariatric surgery.”