Nearly a million Australians (aged 18 and over) had type 2 diabetes in 2017 – 2018 (ABS). This information is only based on self-reported data, so is likely to underestimate the real prevalence of this disease. Type 2 diabetes is a complex condition in which the body becomes resistant to the normal effects of insulin, and the pancreas gradually loses the capacity to produce it.Â
Type 2 diabetes develops over a long period of time (many years). As the body’s insulin becomes increasingly ineffective at managing glucose levels in the blood, the pancreas responds by producing more insulin to manage blood glucose levels. Overproduction over a long period of time essentially causes the cells in the pancreas that produce insulin to ‘wear themselves out’. Type 2 diabetes presents itself as a combination of both ineffective insulin and insufficient amounts of insulin.Â
Is obesity a cause of type 2 diabetes?
Obesity is a risk factor for type 2 diabetes as it plays a role in its development: fat deposits around major organs contribute to elevated levels of fatty acids and cytokines, that mediate insulin resistance and inflammation. Put simply, an obese body is more at risk of developing insulin resistance and type 2 diabetes. The current medical approach (in addition to suitable medication where necessary) is advising patients to lose weight through lifestyle changes such as diet and increased exercise.
Obesity promotes type 2 diabetes; weight loss counteracts it
Type 2 diabetes is a progressive disease as it continues to deteriorate beta-cell function over time, and many doctors favour aggressive weight loss approaches as early as possible. Research has shown that it is possible for some people with type 2 diabetes to achieve remission. Remission does not mean that it is ‘cured’ or ‘reversed’, but that those people now have normal blood glucose levels (below type 2 diabetes level). If you are living with obesity and type 2 diabetes and have been for some time, it is not easy to lose weight. Eating behaviours have been established for many years, meaning the body has established a much higher weight set point, making it incredibly difficult for an obese person to lose weight and maintain that weight loss long-term with just diet and exercise alone.
Bariatric surgery & type 2 diabetes remission
Type 2 diabetes is considered a key morbidity that justifies the risk of weight loss surgery. Those living with obesity and diabetes are strong candidates for bariatric surgery, and if it is considered early it may help preserve beta-cell function and slow the progression of other diabetes related complications.Â
Bariatric surgery options, such as the gastric bypass procedure or sleeve gastrectomy, increase satiety and decrease hunger, physiologically encouraging your body to lose weight. The significant weight loss achieved by bariatric surgery can lead to remission of type 2 diabetes in around three out of four cases (NIH). How? Bariatric surgery helps to restore glycemic control by a combination of calorie restriction, enhanced insulin sensitivity and increased insulin production. Patients who have had weight loss surgery, with the appropriate follow-up, are more likely to maintain their new healthy weight long-term.Â
If you have type 2 diabetes, are living with obesity and would like to know more about weight loss surgery, and if you are a suitable candidate, then please contact our practice on (02) 9553 1120 to arrange an appointment with one of our specialists.Â
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