November is traditionally Diabetes Awareness Month, but for millions who have this disease, their awareness lasts a lifetime. Nearly 30 million people in the U.S. have diabetes; another 86 million are projected to be pre-diabetic, without any knowledge of susceptibility. It is chronic, relentless, and progressive, yet by no means is it a life sentence. Through bariatric surgery and lifestyle changes, Type 2 diabetes can be reversed.
“Without doubt, bariatric surgery is one of the most effective procedures to treat morbid obesity and diabetes,” said Dr. Nestor F. de la Cruz-Muñoz, M.D., chief of the Division of Laparoendoscopic and Bariatric Surgery Department at the University of Miami Hospital, part of University of Miami Health System, commonly referred to as UHealth. “More than 200,000 procedures are performed every year in this country, and approximately half a million worldwide.”
Type 2 diabetes is a metabolic disease characterized by high blood sugar (glucose) levels resulting from the body’s inability to adequately utilize the insulin made by the pancreas. In patients with Type 2 diabetes, lack of response to insulin causes hyperglycemia. Type 2 is more prevalent than Type 1, but the common thread is that the body doesn’t process enough glucose. The hormone that is manufactured in the pancreas helps absorb sugar to promote energy and balance blood-glucose levels. When the body doesn’t generate enough insulin or doesn’t adequately utilize the insulin produced diabetes is a real possibility.
“Obesity with its underlying factor of diabetes has multiple complications,” says Dr. de la Cruz-Muñoz. “It accelerates hardening and narrowing of the arteries (atherosclerosis), leads to strokes and coronary heart disease.”
An excessive sugar overload in the body of a diabetic patient can result in a number of ramifications. The disease can affect the eyes, kidneys, heart, brain, liver, and legs, and even the feet and nerves (diabetic neuropathy). With Type 2, the body is resistant to the effects of insulin, so in order to cope with the problem more insulin is required to achieve the same effect.
“The job of insulin is to allow glucose to get into cells in the bloodstream, but when the cells do not use the insulin correctly, the glucose piles up and creates a phenomenon called ‘insulin resistance,” says Dr. de la Cruz-Muñoz. “Obesity is the biggest risk factor for Type 2 diabetes, as excessive body fat effects the production of insulin, as well as how it’s stored and used.”
Dieting, exercise, and a determined effort to shed pounds can also help reverse Type 2, or at the very minimum, delay its onset and progression.
“A poor general lifestyle and bad eating habits play a huge role in the disease,” says Dr. de la Cruz-Muñoz. “Through surgical intervention, along with nutritional guidelines, and a regimented plan of post-operative treatment, the chances of reversing Type 2 diabetes are very real.”
The twin epidemics of obesity and Type 2 diabetes are on the rise. Of particular concern is the increasing prevalence of obesity among children. Obesity is a major contributing factor that leads to as many as 2.5 million deaths every year worldwide, 400,000 within the U.S. This death rate is second only to the results of smoking cigarettes. There is a direct relationship between increasing body mass index (BMI) and the risk of dying prematurely. The general life expectancy of people in the U.S. is nearly 80 years. Only one is seven obese individuals will reach that age. For the morbidly obese, the average life expectancy is reduced by nine years for women and 12 years for men.
But, all the news is not bad. The bright light is that studies have shown unequivocally that diabetes-related morbidity and mortality declines significantly post-operatively, and the improvement in diabetes control is long lasting. Surgical intervention procedures such as Roux-en-Y Gastric Bypass (RYGBP), and Biliopancreatic Diversion (BPD) are impressive, effective treatments. Other proven effective procedures include Vertical Banded Gastroplasty (VBG) and Laparoscopic Adjustable Gastric Banding (LAGB).
Weight loss surgery can make a huge difference for people with Type 2 diabetes. One study tracked 400 people, and post-operatively over a six-year period, 62 percent showed no signs of diabetes, and their blood pressure, cholesterol and triglyceride levels were within normal limits. In addition, most lost up to 50 percent of their weight, which contributes to a happy, healthier lifestyle.
To learn more about your weight loss options from the University of Miami Health System, call 305-243-4400 or visit UHealthMedicalWeightLoss.com.
Dr. Nestor F. de la Cruz-Muñoz, M.D. is a nationally and internationally renowned bariatric surgeon and medical director for Bariatric Surgery at University of Miami Hospital, part of UHealth — University of Miami Health System. Dr. de la Cruz-Muñoz founded and serves as surgical director of Miami’s Surgical Weight Loss Institute. His practice focus is general, bariatric, and advanced laparoscopic surgery.
He is chief of the Division of Laparoendoscopic and Bariatric Surgery Department and co-director of the Center of Excellence for Laparoendoscopic and Minimally Invasive Surgery. Dr. de la Cruz-Munoz was recently appointed to the Bariatric Surgical Review Committee, where he will work closely with other practicing bariatric surgeons to identify hospitals that meet the requirements to become Centers of Excellence.
Dr. de la Cruz-Muñoz earned his medical degree from the University of Miami School of Medicine, after graduating with a Bachelor of Science in Biology from Duke University in Durham, North Carolina. He completed his residency in general surgery at Jackson Memorial Hospital in Miami, and became chief resident in 1999.
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