Gastric Bypasses in Diabetic Patients May Reduce Long-Term Mortality Rates

For a long time, diabetes has been one of the most dangerous diseases when left untreated. This condition alters the way in which the body produces and reacts to insulin, the hormone which helps regulate blood sugar levels and plays a vital role in the person’s metabolism. Type 2 diabetes, the most common variation of the disease, is usually caused by the person lifestyle habits and is characterized by a decreased insulin production by the pancreas when the person eats sugary meals in excess. The pancreas simply can’t keep up with the demand, so the structures charged with the production of insulin wear out at an accelerated pace, elevating the person’s blood sugar levels permanently.

Type 1 diabetes is much less common and manifests early in the person’s life — usually before 30 years of age. It is an autoimmune disease, as the person’s own immune system targets and destroys the insulin-producing cells, causing a complete shortage of the hormone, and requiring the patient to depend on insulin injections throughout his or her entire life. In stark contrast to type 2 diabetes, the person cannot forgo alternative treatments or healthier lifestyles in order to live with type 1 diabetes, as the production of insulin is halted entirely.

Diabetes, in both its variations, is characterized by constant fatigue, and increased thirst, urination, and appetite. The person may also feel nauseous, experience vomiting, and weight loss despite being increasingly hungry as the disease progresses. These symptoms can, in turn, affect the patient in other ways, such as by creating increased irritability, insomnia, blurry vision, and anxiety. Lastly, diabetes can also cause the person to lose sensation or to experience tingling in their feet while causing their faces to turn red as if constantly blushing.

When it comes to the disease itself, diabetes is not a condition which can be cured. Instead, the patient must learn to live with it and adjust their lifestyles accordingly, in the case of type 2, or to rely on insulin injections for the rest of their lives when it comes to type 1 diabetes.

In type 2 diabetes, the reduction of insulin is gradual as the cells that produce it slowly wear out and become inactive. In this sense, the person may rely on medication to regulate their levels of blood sugar, alongside undergoing lifestyle changes to control the progress of the disease. for recently-diagnosed patients, the self-monitoring of blood sugar levels must be combined with education on the disease in order to extend his or her life expectancy. Additionally, risk factors such as high blood pressure, cholesterol, and albumins must also be kept in check in order to reduce the person’s mortality rate.

To this end, the person must adopt healthier lifestyle habits, such as exercising regularly. Aerobic exercises, in particular, are very effective at extending the person’s life expectancy by reducing blood sugar levels and increasing the body’s sensitivity to insulin. Exercise, however, must be complimented with an appropriate diet; one that, if possible, will revolve around low amounts of sugary foods. If the diet has not contributed to reduced levels of blood sugar in the person after 6 months, at most, medication must be used as an alternative method to achieve this end. Metformin is the first option for this purpose, and these can be used alongside insulin shots in the most severe cases where blood sugar levels climb to dangerous levels.

There are several methods anyone can use in order to keep the symptoms of type 2 diabetes at bay and prolong their life expectancy in the process. However, researchers have recently discovered an additional procedure which, if used on the right types of patients, can contribute to control diabetes symptoms and dramatically reduce the long-term mortality rates of those who suffer from the disease.

Gastric bypass for diabetes patients

A gastric bypass is a surgical procedure through which several alterations are made to the patient’s stomach and small intestines, significantly modifying the way they deal with food and reducing the number of calories absorbed per meal. The procedure is twofold: at first, the surgeon will use staples to reduce the upper section of the person’s stomach, decreasing the amount of food needed for him or her to feel full with each meal. Second, the surgeon will then connect an area of the small intestines called the jejunum to a hole on the now-smaller stomach pouch, reducing the distance that food travels in the digestive tract, and therefore decreasing the amount of calories absorbed with each meal. Up until some years ago, the procedure could only be performed through open surgery, which left the patient with a large and unsightly scar on the abdomen. Nowadays, the surgery can be performed through the use of a laparoscope, significantly reducing the scar tissue (only 6 small incisions are made on the person’s abdomen), the recovery time, and the length of the hospital stay after the surgery.

As a result of the bypass, the person will experience a number of effects, both of the positive and negative varieties. The main objective is to promote weight loss in the patient, which is achieved through the reduced appetite and by feeling full with less food, all of which are created by the bypass itself. The tradeoff is that, due to the food not traveling through the entire digestive tract, fewer nutrients are absorbed from it. In this sense, the person must also undergo a change in diet and lifestyle in order to perpetuate the benefits produced by the procedure. Alternatively, if he or she continues eating in excess after the procedure is done, the small part of stomach left to receive the meals can stretch out to its regular size, forfeiting the purpose of the surgery in the first place.

Gastric bypass surgery has been available for the general public since the early 90’s, in the open surgery variation. Nowadays, they are performed by the aforementioned laparoscopy method.

Recently, a team of researchers led by Michelle R. Lent, PhD, of the Geisinger Clinic in Danville, Pennsylvania, studied the mortality rates of diabetic patients who had also undergone gastric bypass surgery of the Roux-en-Y variation, and compared it to a control group comprised of subject that suffered from a disease, but had not undergone any type of surgery to correct and control their weight.

The study consisted of 2,428 diabetic patients, 625 of which that had undergone gastric bypass surgery, and 1803 who did not. The subjects’ electronic health record data was compared to both a control group of diabetic patients who had not undergone surgery and a group of non-diabetics who had also undergone gastric bypass surgery. When compared to the latter group, there were no significant changes in the long-term mortality rates of the patients. However, when compared with the former, diabetics who had gone through with gastric bypass surgery had fewer deaths from cardiovascular disease, respiratory complications, and diabetes itself.

Despite still lacking significant studies on the subject, there is definitely a relation between gastric bypass surgery and the reduction of long-term mortality rates of diabetic patients. Perhaps the findings of Lent & Co. will help to spark interest in the subject, and contribute to the research on alternative methods to increase the life expectancy of individuals that suffer from diabetes.