Can metabolic surgery help in controlling type 2 diabetes?

Question

Hello doctor,

I am a 52-year-old female, 5 feet 4 inches tall, and weigh 298 pounds. I have been living with uncontrolled type 2 diabetes for 15 years. Despite taking 100 units of insulin daily, along with oral medications, my A1C is still 10.8. Over the years, I have developed retinopathy, neuropathy in both feet, and stage 3 kidney disease. My endocrinologist has told me that I am running out of options and has strongly recommended metabolic surgery as my "last best hope" to prevent dialysis and possibly amputation.

The problem is, I am terrified of surgery after losing my sister to complications from gastric bypass 12 years ago. Are there safer surgical options available now compared to when she had her procedure? The surgeon has mentioned sleeve gastrectomy and duodenal switch as potential options. What are the current mortality rates for these procedures? I have tried numerous diets without lasting success. In my situation, would the benefits outweigh the risks? Kindly provide your insight.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

Given your uncontrolled diabetes and associated complications, metabolic surgery could indeed be a beneficial option. Surgical techniques and postoperative care have significantly improved over the past decade, making procedures like sleeve gastrectomy and duodenal switch safer.

The sleeve gastrectomy involves removing a portion of the stomach, which reduces its size and helps with weight loss. The duodenal switch is more complex but can be highly effective for severe obesity and diabetes. Both procedures have been shown to improve blood sugar control and reduce the need for diabetes medications.

Mortality rates for these surgeries are relatively low, generally less than one percent, and the benefits often outweigh the risks, especially in cases like yours where diabetes is poorly controlled. It is crucial to discuss your concerns with your surgeon and endocrinologist to make an informed decision.

I hope this has helped you.

Kindly follow up if you have more doubts.

Thank you.