section_path: Management/Surgery
section_name: Surgery
paragraph_text: Surgery
  
  Weight loss surgery in those with obesity and type 2 diabetes is often an effective measure. Many are able to maintain normal blood sugar levels with little or no medications following surgery and long-term mortality is decreased. There is, however, a short-term mortality risk of less than 1% from the surgery. The body mass index cutoffs for when surgery is appropriate are not yet clear. It is recommended that this option be considered in those who are unable to get both their weight and blood sugar under control.
  
  A pancreas transplant is occasionally considered for people with type 1 diabetes who have severe complications of their disease, including end stage kidney disease requiring kidney transplantation.
  
  Diabetic peripheral neuropathy (DPN) affects 30% of all diabetes patients. When DPN is superimposed with nerve compression, DPN may be treatable with multiple nerve decompressions. The theory is that DPN predisposes peripheral nerves to compression at anatomical sites of narrowing, and that the majority of DPN symptoms are actually attributable to nerve compression, a treatable condition, rather than DPN itself. The surgery is associated with lower pain scores, higher two-point discrimination (a measure of sensory improvement), lower rate of ulcerations, fewer falls (in the case of lower extremity decompression), and fewer amputations.