What happens when a severely obese, diabetic patient undergoes weight loss (bariatric) surgery? If type 2 diabetes is truly a chronic, incurable progressive disease, then surgery will not alter the natural history.
According to conventional medical wisdom, long standing type 2 diabetics have very high insulin resistance provoking increased insulin secretion from the pancreas. Over time, the pancreas ‘burns out’ and insulin production falls. As the insulin falls, it is no longer able to compensate for insulin resistance and blood glucose rises, triggering the diagnosis of type 2 diabetes.
Once the pancreas burns out, nothing will revive it, meaning that type 2 diabetes is destined to progress and nothing can change that. Since this abnormality is irreversible, the diabetes should continue unabated despite bariatric surgery. Right?
Actually, in virtually all cases, the type 2 diabetes completely disappears!
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