Life After Weight Loss Surgery: Can It Cure Type 2 Diabetes?

Carole Means weighed more than 500 pounds until she underwent bariatric surgery. After losing weight, some people like Carole experience type 2 diabetes remission. But is diabetes really gone for good?

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Three years ago, diabetes was just one of Carole Means' many health problems. At age 48, she weighed 515 pounds, and her heart was three times its normal size. Her blood glucose was in the 400s, she was on insulin and glucose-lowering pills, and her kidneys were failing. Yet her physical agony wasn't as painful as the emotional toll the weight took. In four years, she never saw her son play high school football, and she didn't attend his graduation. She rarely left her Des Moines home.

Today, Carole spends two hours a day at a gym and loves to chase after her grandchildren. "I missed out on so much," she says wistfully. "But I'm making up for it now. My husband can barely keep me at home."

Carole lost the bulk of her weight after undergoing surgery that reduced her stomach to the size of a golf ball. She had to make drastic, permanent changes in what and how she eats, but she says it's been worth it. She weighs about 130 pounds now and takes no diabetes medications.

"My doctor says I no longer have diabetes," she says. "I know why I didn't die: I needed to stick around to share my story and inspire others to transition from hopeless to hopeful."

Is Diabetes Remission Possible?

While Carole's experience is not the norm, weight loss and the plummeting glucose levels that often follow bariatric surgery can be dramatic. Most people lose about 56 percent of their excess weight, with the range being 45-65 percent (66-110 pounds) based on data from the various surgeries during one to 10 years of follow-up.

"The heavier you are, the longer it takes," says Margaret Furtado, RD, bariatric nutrition specialist at the University of Maryland Medical Center in Baltimore and author of The Complete Idiot's Guide to Eating Well After Weight Loss Surgery (Alpha, 2009). Men lose weight faster. They hit their maximum pounds lost about nine to 12 months after surgery; women take about 12-18 months. As with any weight loss plan, expect some weight regain -- "10-20 percent is common," Furtado says.

Following bariatric surgery, 45-95 percent of people experience type 2 diabetes remission, depending on the type of surgery and follow-up care, among other factors. Weight loss and diabetes remission rates are better for the Roux-en-Y procedure -- the surgery Carole had -- and other more invasive surgeries compared with the adjustable gastric band.

Five or more years after surgery, complete diabetes remission rates wane. Also, it's important to note that the surgery does not erase prior damage or halt the progression of type 2 diabetes.

"Our large study with more than 4,000 people with diabetes who had Roux-en-Y surgery showed that five years after surgery, 35 percent had redeveloped type 2, with an average remission being just over eight years," says David E. Arterburn, M.D., the study author and associate investigator at the Group Health Research Institute in Seattle.

One statistic is certain: The number of surgeries in the United States rose over the last decade from 80,000 to 160,000. Less than 1 percent of the hundreds of thousands of people who may experience health benefits from metabolic surgery actually have it.

 

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