Over the past year, news headlines have suggested that Type 2 diabetes and obesity can be safely "cured" by bariatric surgery.
Patients who undergo this surgery, which bypasses part or all of the stomach, typically lose weight rapidly and may no longer need diabetes medication when they leave the hospital.
Surgery, however, has its own risks, including a significant number of complications that require re-hospitalization. In addition, follow-up studies demonstrate that many patients regain weight and have a re-emergence of their diabetes.
Although we do not fully understand why blood sugars normalize so rapidly after bariatric surgery, a study presented at the 2012 Obesity Society International compared low-calorie dieting to surgery. The study found equivalent effects on insulin and blood sugar levels, suggesting that a dramatic drop in calorie intake is the initial key.
The focus of diabetes therapy is prevention: Avoid or minimize the impact of damage to the eyes, kidneys, nerves and blood vessels. The usual therapeutic approach is to control blood sugars as much as is safely possible. This usually requires multiple medications and weight gain is a common side effect.
However, most people with Type 2 diabetes are already obese, and further weight gain as a result of well-intentioned therapy can increase psychological and physical distress. Weight gain means higher medication dosages and longer medication lists.
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