Diabetes and cardiovascular disease: prevention with bariatric surgery

Type 2 diabetes mellitus (DM2) is a silent disease, since its clinical manifestations and complications do not appear immediately and people can go years without being diagnosed.

In 2017 it was estimated that 425 million adults in the world had DM2, and that by 2045 this number would rise to 629 million. DM2 is the second leading cause of death in Ecuador, and the number of patients with this disease continues to increase due to factors such as sedentary lifestyle and poor diet (excessive consumption of rice, fat, bread and soft drinks). These factors often lead to being overweight or obese from an early age, which greatly increases the risk of developing DM2.

Cardiovascular disease is a term used to refer to conditions that affect the heart or blood vessels. When the blood vessels are affected, organs such as the brain (cerebrovascular disease), the kidneys, the heart, and others can be compromised. The most common cardiovascular diseases are coronary heart disease and cerebrovascular disease.

Coronary heart disease is associated with atherosclerosis (accumulation of fatty substances in the walls of the arteries), and manifests itself through angina pectoris or myocardial infarction. On the other hand, cerebrovascular disease is evident in the form of acute attacks such as cerebrovascular accidents, which can occur due to obstruction or bleeding of an artery.

Risk factors associated with cardiovascular disease are directly related to excess weight: high levels of cholesterol and triglycerides, arterial hypertension, and sedentary lifestyle, among others. This is why the key treatment for this disease is optimal weight control.

Bariatric surgery (BC) is the best alternative treatment for weight loss, since it helps patients achieve significant and long-lasting weight loss. Studies that have followed patients for 20 years have shown that patients who have undergone BC have better control of diseases associated with obesity (DM2, arterial hypertension and dyslipidemia) and a reduction in mortality compared to patients who have not been operated on.


Furthermore, controlled clinical trials have shown that surgical treatment of patients with DM2 allows for better control of blood glucose, reduced cardiovascular risk factors, and lowered use (or even suspension) of medication.