Can metabolic surgery improve or reverse type 2 diabetes?

Question

Hello doctor,

I am a 45-year-old with type 2 diabetes for the past eighty years and a BMI of 42. I recently read a blog claiming that metabolic surgery can completely reverse diabetes within just a few weeks. Is this possible or exaggerated? How soon after surgery might I see improvements in my blood sugar levels? Would I be able to stop all my medications? The daily insulin injections and constant finger pricks are taking a toll on me and making me feel depressed.

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

You are correct that metabolic (also known as bariatric) surgery has been shown to improve dramatically and sometimes even completely reverse type 2 diabetes mellitus, especially in people with a higher body mass index (BMI) like yours (42).

This is not exaggerated. In many cases, patients see significant improvements in blood glucose levels within days to weeks after surgery, often even before any major weight loss occurs. This rapid effect is due to hormonal changes in the gastrointestinal tract that enhance insulin sensitivity and glucose metabolism.

However, the degree of improvement can vary depending on several factors, like how long you have had diabetes mellitus (you mentioned eight years, which is still quite manageable). How much endogenous insulin is your pancreas still able to produce? The type of surgery performed — Roux-en-Y gastric bypass (RYGB) often has stronger anti-diabetic effects compared to sleeve gastrectomy (also known as laparoscopic sleeve gastrectomy or LSG). In many cases, patients can reduce or discontinue insulin and other antidiabetic medications such as Metformin (Glucophage), Glimepiride (Amaryl), Sitagliptin (Januvia), or Empagliflozin (Jardiance) shortly after surgery, but this must be done under close medical supervision. Some individuals may still require low doses of medication, at least temporarily.

A detailed discussion with your bariatric surgeon will help determine which procedure may be most appropriate for you and provide a better prediction of your likelihood of achieving diabetes remission.

I hope this helps.

Thank you.