HJAR Jul/Aug 2022

HEALTHCARE JOURNAL OF ARKANSAS I  JUL / AUG 2022 57 Samuel Bledsoe, MD, FACS, FASMBS Bariatric and Metabolic Institute Arkansas Heart Hospital beneficial side effects of the procedure for weight loss was a resolution of the diabetes. Now, we are operating on patients for their diabetes, and one of the beneficial side effects of the procedure for the diabetes is the weight loss. Shortly after this joint statement was released, the American Diabetes Association endorsed the recommendations in their “Standards of Medical Care in Diabetes.” Due to the influx of positive data, doctors, patients, and pop- ular media have started normalizing bariat- ric surgery for diabetics. My patient, Scott, is just one of many success stories. He had his sleeve gastrectomy in January 2022. Since then, he has lost 100 pounds. He is off all his hypertensive medications. His sleep apnea is vastly improved. He has gone from a 50-inch waist to a 42-inch waist. The most exciting improvement is the re- sponse his blood sugars have had to the pro- cedure. He is off all his diabetes medications while his HbA1c is now 5, and his continuous glucose monitor runs from 80-100. While he loves the fact that his insulin pump is now unused in a drawer, it’s the quality-of-life improvements that bring a smile to his face. For instance, he can tie his own shoes. His wife can wrap her arms all the way around him for an extra big hug. His energy is back, and he’s more involved in his life. Does he have any other personal goals? Yes … he wants to get back into the go-cart with his grandson. And, that’s a goal we would love for him to attain. n sleeve gastrectomy. The trial concluded in 2017, after five years of follow up, noting that “the results of this 5-year follow-up analysis from the STAMPEDE trial showed that bariat- ric surgery was superior to intensive medical therapy in terms of glycemic control, weight reduction, medication reduction, improve- ment in lipid levels, and quality of life.” Most importantly, a 2021 meta-analysis by The Lancet looked at almost 175,000 pa- tients and noted that the diabetic stood to gain almost a decade in life expectancy after bariatric surgery. In fact, every 8.4 surgeries would be expected to prevent the death of one diabetic over a 10-year time frame. This ability to add good years onto a person’s life is one of the most exciting aspects of weight loss surgery. The studies continue to show not only the remarkable results of bariatric surgery but also the superiority of bariatric surgery over diet, exercise, and behavior modification. This data resulted in a lot of attention. In 2015, the Cleveland Clinic released the “Top 10 Medi- cal Innovations of the Past Decade.”Number three on that list was bariatric surgery for the control of diabetes. In 2016, a joint statement was released by international diabetes organizations and endorsed by nearly 50 medical and surgi- cal societies. That statement detailed a new algorithm for the treatment of the diabetic that recommended any diabetic with a BMI of over 40, or an uncontrolled diabetic with a BMI of over 35, should be sent for bariat- ric surgery. This completely changed the ra- tionale for surgery for those suffering with diabetes. Historically, bariatric surgeons would start with the obesity, and one of the “In 2015, the Cleveland Clinic released the ‘Top 10 Medical Innovations of the Past Decade.’ Number three on that list was bariatric surgery for the control of diabetes.”