Jewels Doskicz is a registered nurse, freelance writer, patient advocate, health coach, and long-distance cyclist. Jewels is the moderator of Diabetic Connect’s weekly #DCDE Twitter chat, and she and her daughter both live healthfully with type 1 diabetes.
Predicting the extinction of type 2 diabetes after gastric bypass surgery can be a hazy process; thankfully, there's a new scoring system to help predict the gamble.
As a surgical nurse, I think it's important to begin this conversation with the naked truth: most diabetic patients have multiple health risks, not just type 2 diabetes or pre-diabetes, by the time they decide to visit the operating room.
This population is plagued by a number of common diagnoses such as:
- High blood pressure
- High cholesterol
- Cardiac issues
- Joint problems
- Thyroid malfunctions
- Fatty liver disease
- Sleep apnea
- Limited mobility
Clearly, the pipe dream doesn't begin and end with eliminating diabetes; patients are grappling with the possibilities of improving multiple areas of their lives.
New scoring system
According to Diabetes Health, there's a new system called DiaRem used to assess post-operative diabetes remission. Four factors are analyzed in his process: age, insulin use, hemoglobin A1c, and other drugs used to control type 2 diabetes.
This tool was created to help providers scientifically predict a patient's chances of putting diabetes into remission.
These surgeries obviously don't come without a long list of risks and benefits, beginning with gastrointestinal issues and malnutrition. Also, the emotional expense of the surgery can be ruinous to individuals and their marriages.
The potential financial impact is astounding. According to Dr. Mark Hyman in the Huffingon Post: "If the nearly 30 million diabetics in America took advantage of this new miracle cure at $25,000 a pop, it would cost three-quarters of a trillion dollars ($750,000,000,000).
Permanently altering the physical body in such a profound way cannot be taken lightly - which is why psychological counseling is an integral part of a patient's pre-operative experience. Most procedures reduce the size of the stomach by 90%.
Is gastric bypass our solution for type 2 diabetes?
Gastric bypass is an end-of-the-road treatment when all other possibilities have failed. In the end, it all boils down to the food we eat - even after gastric bypass surgery. Weight will be lost through surgery or lifestyle changes - and it can be regained with either choice (trust me, you can be 300 pounds again after going through gastric bypass surgery).
Why does diabetes disappear?
Dr. Mark Hyman controversially refers to this population as having "diabesity," a term interchangeably used for type 2 diabetes. Playing devil's advocate, Dr. Hyman believes it's the forced diet changes associated with the surgery that effectively deem type 2 diabetes extinct - not the surgery itself.
He explains that "diabetes can disappear within a week or two while people are still morbidly obese." He attributes this to the drastic dietary changes that can also occur without visiting a surgeon.
Can diabetes reappear?
Of course it can, or it may never resolve post-operatively to begin with.
There are ways to fool weight loss procedures, and those with the desire find the means. Diet changes aren't easy, but then again, gastric bypass surgery isn't either.