Bariatric surgery has focused on the metabolic effects and benefits of surgery, rather than just losing weight over time.
Although many concomitant diseases are improved depending on the weight lost as a result of bariatric surgery, the most affected metabolic diseases are type 2 diabetes and metabolic syndrome. Improvement is also achieved in hyperlipidemia, hypertension and cardiovascular diseases.
DIABETES:
After metabolic surgery, up to 90% improvement is observed in patients with diabetes for less than 5 years. It was observed that long-term mortality rates were also decreased in these patients who underwent bariatric surgery.
With randomized controlled studies in patients with obesity and poorly controlled diabetes; It has been shown that patients who underwent surgery achieved much better glycemic control (HbA1c < 6%) than that achieved with intensive medical therapy (with or without medication). At the same time, a great decrease in the dependence of patients who underwent surgery on diabetes drugs was observed.
The American Diabetes Association includes bariatric surgery in its treatment algorithm in the treatment of type 2 diabetes. According to the treatment guidelines, bariatric surgery should be considered for adults with a BMI of ≥35 kg/m2 and type 2 diabetes and for whom diabetes control is difficult with medical treatment.
The International Diabetes Federation (IDF) recommends that metabolic surgery can be considered even if the patient’s BMI is as low as 30, if glycemic control cannot be achieved despite optimal treatment.
METABOLIC SYNDROME:
The metabolic syndrome is characterized by central obesity, glucose intolerance, dyslipidemia and hypertension. This situation is attributed to the increased inflammatory state that develops as a result of increased cytokine synthesis from adipose tissue. All medical problems associated with metabolic syndrome respond to surgery for weight loss.