Type 2 diabetes mellitus is a chronic disease strongly linked to obesity and overweight. Although it can occur at any age, its prevalence is higher in adults, and it is increasingly common to detect it at younger ages, especially due to the rise in childhood obesity. But is it possible to cure type 2 diabetes?
The Relationship Between Obesity and Type 2 Diabetes
It is essential to understand that obesity is not only a risk factor for type 2 diabetes but also a chronic low-grade inflammatory disease. For many years, the body of a person with obesity experiences cellular-level inflammation, which over time affects the functioning of all organs and systems in the body, including the pancreas.
The process of type 2 diabetes begins when the body cannot efficiently use glucose (the sugar we get from food) as a source of energy. For cells to absorb glucose, insulin—a hormone that acts as a “transporter” to carry glucose into the cells—is needed. However, in people with obesity and elevated levels of inflammation, the mechanisms that allow glucose absorption into cells become blocked. As a result, glucose is not effectively used, remains in the blood, and causes what is known as hyperglycemia.
The Vicious Cycle: Hyperglycemia and Hyperinsulinemia
When the body detects elevated blood glucose levels, it increases insulin production in an attempt to control the excess glucose. However, due to inflammation and blockages in glucose transporters, insulin cannot perform its function properly. This leads to hyperinsulinemia, an excess of insulin in the body.
This process becomes a vicious cycle: the pancreas continues producing more insulin, but glucose levels remain high in the blood, eventually leading to insulin resistance. If this cycle persists for a long time, pancreatic cells become worn out, reducing the pancreas’s ability to produce insulin, which results in the development of type 2 diabetes.
Traditional Treatment and the Need for a Comprehensive Solution
Traditionally, type 2 diabetes is treated with oral medications that help improve pancreatic function. These drugs can increase insulin production if some functional pancreatic cells remain. However, over time, pancreatic reserve may be depleted, forcing many patients to rely on injectable insulin treatment to control blood glucose levels.
The Solution: Bariatric Surgery
To address the root of the problem, it is necessary to eliminate the inflammatory substances caused by excess fat in the body. Bariatric surgery, a surgical treatment for obesity, has proven effective in rapidly reducing inflammation, even without significant weight loss. In fact, many patients experience regulation of their glucose levels within days after surgery.
Bariatric surgery modifies the gastrointestinal anatomy in a way that activates intestinal hormones known as incretins, such as GLP-1 and peptide YY. These hormones have a regenerative effect on the pancreas, improving the function of beta cells, which are responsible for insulin production. This enables adequate insulin production in both quantity and quality.
Additionally, the surgical procedures also modify the gut microbiota and the amount of bile acids in the digestive tract, significantly reducing inflammatory substances in the body. This improvement in glucose regulation by the cells contributes to the control of type 2 diabetes.
Cure for Type 2 Diabetes?
Although the term “cure” for type 2 diabetes has not yet been officially established, there are cases where patients, after undergoing bariatric surgery, have stopped needing antidiabetic medications or injectable insulin. Some of these patients have maintained normal blood glucose levels for more than 20 years after the procedure, indicating that bariatric surgery can offer a long-lasting solution for disease management.
Type 2 diabetes is a complex disease strongly associated with obesity and chronic inflammation. While a definitive “cure” cannot be claimed in all cases, treatments such as bariatric surgery have proven effective not only in reducing weight but also in significantly improving glucose control and pancreatic function. By addressing the root of the problem, patients may experience lasting improvements in their health and quality of life, opening new possibilities for those battling this disease.
