Issue link: https://viewer.e-digitaledition.com/i/1472735
DIABETE S AND OBE SIT Y affect a large portion of people worldwide. Projections show that by 2030, half of the U.S. pop- ulation will be obese and 25% will have severe obesity. Diabetes affects 10% of Americans, and the CDC reports that 26.8% of adults 65 and older have dia- betes. Additionally, 90% of those with Type 2 diabetes are obese or overweight, supporting a strong association between obesity and Type 2 diabetes. Obesity and diabetes are associated with significant morbidity and mortality. Obesity is the second-leading modifiable risk factor for premature death behind smoking. Due to cellular changes and cytokine production creating a chronic inflammatory state in response to insulin resistance and excess adipose tissue, dia- besity can increase the risk of developing various other life-threatening or debili- tating conditions. Diabesity increases the risk of macrovascular and microvascular diseases and cancer, including cardio- vascular disease, stroke, nephropathy, retinopathy, cognitive impairment, erec- tile dysfunction, periphera l vascular disease and amputations. DIABESITY: A MODIFIABLE RISK FACTOR With bariatric surgery, Type 2 diabetes and obesity are preventable and often reversible, according to metabolic and bariatric surgeon Hesham Atwa, MD, FACS, FASMBS, Founder and Clinical Director of Long Island Laparoscopic Doctors, Director and Chief of Surgery and Director of Robotic Surgery at St. Charles Hospital, and Chief of General Surgery at Mather Hospital Northwell Health. The ma in adva nce over the past two decades is the incredible safety profile of bariatric surgery. Randomized controlled studies sup- port this assertion. Metabolic/bariatric surgery reduces the risk of: + Atrial fibrillation (22%) + Cancer (37%) + Coronary artery disease (20%) + Heart failure (62%) + Myocardial infarction (40%) + Nephropathy (45%) + Premature death (41%) + Stroke (42%) Patients who underwent metabolic surgery and subsequently managed to control their blood glucose for a decade after surgery experienced an even greater reduction in risk of cancer: 60%. PROTECTION AGAINST COVID-19 COMPLICATIONS Bariatric surgery also reduces the risk of complications or death from COVID-19. People with diabetes are more likely to have serious complications from COVID- 19, including sepsis and septic shock, according to the A merica n Diabetic A ssociation. A nd obesit y triples the risk of hospitalization from a COVID-19 infection, according to CDC statistics. Metabolic/bariatric surgery addresses both these risk factors — a study in JAMA Surgery found that people who had previously had bariatric surgery and later caught COVID-19 had 60% less risk of severe disease and 63% less need for supplemental oxygen. DIABESITY TREATMENTS Treatment options for diabesity include: + L i fe s t y l e c h a n g e s , s u c h a s d i e t and exercise + Pharmacologic treatment of diabetes, including insulin and oral hypoglyce- mic and GLP-1 agonists. GLP-1 agonists can also aid in weight loss. + Pharmacologic treatment of obesity, including traditional weight loss med- ications and Plenity, a new hydrogel pill made of plant-derived cellulose that expands up to 100 times its size to increase satiety. Plenity was FDA approved for patients with a BMI of 25–40 in 2019. + Non-inva sive procedures li ke t he Orbera balloon, which is placed in the stomach endoscopically for a temporary period of six months. Patients lose an average of 20–50 pounds, and the bal- loon can be used in conjunction with other weight loss medications. Metabolic ba riatric surger y offers severa l laparoscopic options that are Hesham Atwa, MD, FACS, FASMBS, and Long Island Laparoscopic Doctors: Surgical Solution to Diabesity Proves Most Effective Treatment BY ROBIN OVERBAY THOUGH THE TERM MAY SOUND NOVEL, DIABESIT Y IS DEFINED BY MERRIAM-WEBSTER A S "OBESIT Y A SSOCIATED WITH DIABE TES." THE SURGEONS AT LONG ISL AND L APAROSCOPIC DOCTORS ARE HIGHLY FAMILIAR WITH BOTH THE CONDITION AND THE SURGICAL TRE ATMENT OF DIABESIT Y, WHICH HA S PROVEN TO BE SUPERIOR TO PHARMACOTHER APY AND LESS RISK Y THAN SE VER AL ROUTINE L APAROSCOPIC SURGERIES IN VARIOUS STUDIES. 1 4❱❱❱❱❱ S U R G I C A L S O L U T I O N S