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Bariatric Surgery For Type 2 Diabetes: FAQs

September 08 2025

A woman in a lab coat reads about bariatric surgery for type 2 diabetes on her tablet.

kate haggerty — *By: Dr. Kate Haggerty, MD*

As a physician specializing in obesity and metabolic health, I often help patients explore their options for treating obesity and type 2 diabetes. Although I am not a surgeon, I explain that one of the most effective options available is metabolic surgery, commonly referred to as bariatric surgery. Below are some answers to frequently asked questions that I hear from patients considering bariatric surgery for type 2 diabetes.

Weight Loss Surgery for Type 2 Diabetes: FAQs

What is bariatric surgery?

Bariatric surgery, also known as weight loss surgery, encompasses a category of surgical procedures that promote weight loss. It works by modifying the digestive system to function differently. It’s an effective treatment option for individuals with obesity, especially those with class III obesity.

Is bariatric surgery for more than just weight loss?

Many patients wonder if bariatric surgery is for more than just weight loss. Bariatric surgery is a highly effective treatment for patients struggling with both diabetes and obesity. Research indicates that nearly 90% of type 2 diabetes cases are linked to obesity (Rubino et al., 2010). While there are newer medications available, weight loss surgery often proves to be the most effective option for eligible patients (American Society for Metabolic and Bariatric Surgery [ASMBS], 2023). Surgery can change the structure of the gastrointestinal tract, leading to long-term improvements in hormonal pathways that regulate glucose metabolism and appetite. Many patients experience significant weight loss and improved insulin sensitivity, which can even lead to type 2 diabetes remission (American Diabetes Association [ADA], 2023).

Who qualifies for bariatric surgery?

Patients may be under the impression that bariatric surgery is not an option for them due to common misconceptions and outdated information. In fact, many of my patients are shocked to discover they may be a good candidate for bariatric surgery. One misconception is that you need to have a BMI greater than 40 to consider weight loss surgery. For example, a 5’6″ woman living with diabetes and a weight of 186lbs, may find weight loss surgery to be an excellent treatment option. Overall, it’s important for patients to have a thorough discussion with their healthcare provider about their medical history and mental health when considering this treatment method.

Recommended Criteria for Bariatric Surgery Patients:

A body mass index (BMI) of ≥35 kg/m², regardless of other health issues.
A BMI of ≥30 kg/m² if you have type 2 diabetes.
A BMI of 30 – 34.9 kg/m² if they have weight-related comorbid conditions and haven’t achieved significant weight loss through non-surgical methods.

Insurance coverage can vary, so it’s important that patients check their plan, as some insurances have different BMI criteria.

A nurse goes over questions about bariatric surgery for type 2 diabetes with a patient.

How will bariatric surgery affect my long-term health if I have diabetes?

Bariatric surgery can lead to diabetes remission in about 30% – 60% of patients, particularly those with less severe disease (Schauer et al., 2017). It often results in better glycemic control, reduced need for diabetes medications, and lower healthcare costs (Buse et al., 2020). Many patients also experience improvements in other health conditions related to obesity, such as hypertension and high cholesterol, joint pain, sleep apnea, and quality of life (ADA, 2023).

What types of bariatric surgeries are available? How do they work?

There are several types of bariatric surgery. The three most common types are:

Roux-en-Y Gastric Bypass: This involves creating a small stomach pouch and rerouting the intestines to limit food intake and calorie absorption.
Sleeve Gastrectomy: In this procedure, a large portion of the stomach is removed, creating a tube-like structure that reduces volume and changes hormonal signals related to hunger.
Biliopancreatic Diversion with Duodenal Switch: This is a more complex surgery that limits both food intake and nutrient absorption.

The gastric band was popular in the past but has since fallen out of favor and more are being removed than put in at this time. “The sleeve” seems to be one of the most common types at this time and is often paired with GLP-1 medications as well. Each procedure has unique benefits and risks, and the choice depends on your individual health status and health goals.

How do Continuous Glucose Monitors (CGMs) and insulin pumps work before and after bariatric surgery?

Before surgery, continuous glucose monitors (CGMs) track blood glucose levels in real time. This information allows for timely medication adjustments to ensure stable blood glucose, which can minimize surgical risks (Buse et al., 2016; Schauer et al., 2017). After surgery, CGMs continue to provide valuable insights into metabolic responses, allowing for better management of diabetes and dietary impacts. Insulin pumps can also be programmed to adjust insulin delivery based on real-time glucose readings, allowing for better control and reducing the risk of postoperative complications such as low blood sugar or hypoglycemia (Buchwald et al., 2004; Weller et al., 2018).

What are the risks and benefits of bariatric surgery for Type 2 diabetes?

Bariatric Surgery Benefits

Substantial weight loss
Improved quality of life
Type 2 diabetes remission up to 80% within one to two years of surgery
Reduced sleep apnea
Lowered hypertension

Bariatric Surgery Risks

Surgical complications
Nutritional deficiencies
Gallstones
Acid reflux

While risks do exist, the mortality rate for bariatric surgery is relatively low at 0.2% to 0.3%. These are just some of the common outcomes of weight loss surgery. Every patient is different, for a full overview of benefits and risks, it’s important for individuals to consult with their healthcare team.

How long is the recovery from bariatric surgery?

Recovery times vary depending on the procedure and individual,, but most patients return to normal activities within three to five weeks. Adjusting to new eating habits may take several months. Initially, they will follow a specific diet plan that starts with liquids and gradually incorporates solid foods. It’s crucial to focus on protein intake and avoid high-sugar and high-fat foods. Lifelong supplementation of vitamins and minerals is also necessary to prevent deficiencies.

Is it normal to gain weight after bariatric surgery?

When discussing weight loss surgery for diabetes, patients often worry about post-op weight gain. They may know a family member or friend who regained weight following surgery. It’s important to understand that each patient’s journey is unique and medicine is always in a state of change and learning. Surgeries, medicines, technology, and education have advanced greatly over the past 10 years, so your aunt’s bariatric surgery journey would likely look different than yours today. Factors such as adherence to dietary guidelines, physical activity, and emotional support play substantial roles in long-term success.

Bariatric surgery is not a “quick fix” but rather a tool that requires ongoing lifestyle modifications for optimal outcomes (Schauer et al., 2017). Studies show that about 20% to 30% of patients may regain some weight within five years post-surgery (Buchwald et al., 2004). This often occurs due to a lack of adherence to post-surgery guidelines, emotional eating, and lack of medical follow-up. With proper follow-up and commitment to lifestyle changes, many patients maintain significant weight loss.

Should I continue my regular diabetes treatment after weight loss surgery for Type 2 diabetes?

Doctors are discovering more about how our genes can affect our risk for obesity, diabetes, and metabolic diseases. Understanding these genetic factors can help doctors create targeted treatments for people who may have specific genetic conditions related to obesity that could make it harder to lose weight the “old fashioned” way (Loos & Yeo, 2022).

Over the past five to ten years, there have been exciting new developments in medications for treating obesity and diabetes. Drugs like GLP-1 receptor agonists and SGLT2 inhibitors are helping people manage their blood sugar levels and lose weight more effectively (Davies et al., 2018; Rubino et al., 2021). Still, some people will benefit the most from both non-surgical and surgical options. Sometimes the medications alone help but are not enough, while in other patients, surgery can help but still not be enough. Often the non-surgical and surgical treatments are staggered (medication before surgery with possible restart of medication after surgery) and require a team-based long-term approach.

Combining these new medications with bariatric surgery for type 2 diabetes can lead to better long-term results for patients. When patients undergo surgery and receive the right medications, they often experience greater weight loss and improved diabetes control (Schauer et al., 2017). It’s essential for patients to have regular check-ups with specialists in obesity and metabolic health. Ongoing support can significantly lower the chance of regaining weight and help maintain better blood sugar levels (Buse et al., 2020).

Bariatric Surgery Myths and Misconceptions

Many patients fear they may not be good candidates for surgery or view it as an “easier” way to lose weight. In reality, it’s a significant commitment involving lifestyle changes and does not guarantee success (Buchwald et al., 2004). Additionally, while the surgery can improve obesity-related health issues, it won’t resolve all medical conditions. Ongoing management is key (ASMBS, 2023). Advancements in surgical techniques have significantly reduced risks, making it a safer option than ever before (ASMBS, 2023).

Understanding Bariatric Surgery For Type 2 Diabetes

In summary, understanding bariatric surgery for type 2 diabetes is essential for making informed decisions about patient health. Compared to the past, there are many new medications and technologies that can greatly improve the experience and outcomes. If a patient is considering this option or has more questions, I suggest reaching out for personalized advice and support with a specialist such as an endocrinologist, obesity medicine specialist, or bariatric surgeon.

Diabetes Care With Advanced Diabetes Supply

As the top provider of diabetes supplies in America, Advanced Diabetes Supply offers an extensive selection of products with exceptional customer service. Following bariatric surgery, endocrinologists may suggest continuing the use of CGMs, blood glucose testing, and insulin pumps. From CGMs like the Dexcom G7 to testing supplies like lancets and test strips, ADS has a wide variety of diabetes care supplies. As the number one provider, ADS offers:

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ADS has an A+ Better Business Bureau rating and accreditations from the ACHC, URAC, and NABP. We make it easy for Medicare beneficiaries to get the diabetic supplies they need easily and efficiently. We accept Medicare and can bill Medicare directly for eligible items.

Unlike other providers, ADS provides a 90-day supply for Medicare beneficiaries, so you only need to reorder four times a year instead of twelve. Contact us today to get the tools you need for effective diabetes management.

References

Arterburn, D. E., Telem, D. A., Kushner, R. F., & Courcoulas, A. P. (2020). “Benefits and Risks of Bariatric Surgery in Adults: A Review.” JAMA, 324(9), 879-887. doi:10.1001/jama.2020.12567.
Banerjee, E. S., Schroeder, R., & Harrison, T. D. (2022). “Metabolic Surgery for Adult Obesity: Common Questions and Answers.” American Family Physician, 105(6), 593-601.
Buse, J. B., Wexler, D. J., Tsapas, A., et al. (2020). “Position Statement: Standards of Medical Care in Diabetes—2020.” Diabetes Care, 43(Supplement 1), S1-S212. doi:10.2337/dc20-S001.
Buchwald, H., Avidor, Y., Braunwald, E., et al. (2004). “Bariatric Surgery: A Systematic Review and Meta-analysis.” JAMA, 292(14), 1724-1737.
Davies, M. J., D’Alessio, D. A., Fradkin, J., et al. (2018). “Management of hyperglycemia in type 2 diabetes, 2018.” Diabetes Care, 41(Supplement 1), S120-S132. doi:10.2337/dc18-0025.
Loos, R. J. F., & Yeo, G. S. H. (2022). “The genetics of obesity: from discovery to biology.” Nature Reviews Genetics, 23(2), 85-104. doi:10.1038/s41576-021-00429-9.
Mechanick, J. I., Youdim, A., Jones, D. B., et al. (2013). “Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient–2013 Update.” Obesity (Silver Spring, Md.), 21 Suppl 1, S1-27. doi:10.1002/oby.20461.
Rubino, F., Nathan, D. M., Eckel, R. H., et al. (2021). “Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations.” Diabetes Care, 44(2), 170-182. doi:10.2337/dc20-0059.
Schauer, P. R., Bhatt, D. L., Kirwan, J. P., et al. (2017). “Bariatric Surgery versus Intensive Medical Therapy for Diabetes — 5-Year Outcomes.” New England Journal of Medicine, 376(7), 641-651. doi:10.1056/NEJMoa1600869.
Sharew, B., Kodur, N., Corcelles, R., & Mauer, Y. (2024). “Bariatric and Metabolic Surgery in the Adult Population: What a Primary Care Provider Needs to Know.” Mayo Clinic Proceedings, S0025-6196(24)00270-2. doi:10.1016/j.mayocp.2024.05.022.
Weller, M. A., Dagan, A., & Hurst, C. (2018). “The Role of Continuous Glucose Monitoring in the Management of Type 2 Diabetes After Bariatric Surgery.” Diabetes Technology & Therapeutics, 20(7), 493-497.

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