When a patient has weight loss surgery, big changes are made in the gastro-intestinal anatomy. These changes most of the time lead to weight loss, and in most cases, they can also improve the patient’s ability to process sugars.
While the exact cause of the body’s ability to process these sugars is not confirmed, some experts say that changes in gut hormones allow the patient to process glucose better. Others point more to the surgery leading to a more effective bile acid metabolism and that surgery can improve the rate of nutrient sensing and metabolism in the intestinal tract. New theories also indicate an improvement in gut microbiota following surgery.
When we operate on someone with diabetes, in a lot of cases patients get an improvement in their diabetes overnight. They then get a second improvement as their weight comes off. This is because of the hormonal changes and improvement in sugar processing that occurs.