Metabolic Surgery for Type2 Diabetes

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India being the diabetic capital of the world, we need to give priority to treating this disease. Currently, available treatment for diabetes is oral hypoglycaemic tablets and insulin which help to control diabetes. But we are looking at something much better, – “A NEW Diabetes Treatment”,  which can cause remission of the disease, not for months, but years.

Diabetes affects the small vessels supplying blood to vital organs in the body, causing, stiffening and narrowing of these vessels. This is medical terms is called microangiopathy. It is important to know that during the day higher the spikes( high values of blood sugar readings), the higher the chance of developing microangiopathies.

So, the major brunt of diabetes is borne by vital organs like the heart, kidneys, brain, eyes and foot. Thus, diabetes is the major cause of blindness, kidney failure, heart attack, and stroke. This has led the WHO(World Health Organization) to consider diabetes an epidemic, predicting it will soon be the 7th biggest cause of death worldwide.

How early are these organs affected in the course of diabetes depends on the duration of diabetes and how well the diabetes is controlled with available medication and insulin. The longer the duration, the more the chances of developing complications. It is seen that after 10 to 15 years, some element of complications does set in even if one tries to maintain good control. This is because every diabetic faces these high spikes at some point or the other, reasons could be multifold eg stress, no dietary control, lack of regular exercise, infections, alcohol and so on.

On average if we consider the patients having heart disease and undergoing open-heart surgery, patients with kidney failure and undergoing dialysis, patients with brain stroke, blindness, foot gangrene, we will find something strikingly common in them. The majority of them will be diabetics over years. Hypertension is another contributing factor. This gives us insight that tackling diabetes is very important, not just getting control, but remission of diabetes is paramount. This will help reduce the complication associated with longstanding and also short duration but uncontrolled diabetes.

This new treatment for Diabetes or the latest diabetes treatment is termed Metabolic surgery or diabetes surgery. It’s more than a decade that this surgery is being performed in Brazil and France and the results have been good. This new treatment for Diabetes is performed via keyholes on the intestine and the stomach and NOT on the pancreas. But this latest treatment for diabetes does indirectly influence the function of the pancreas, secretion of insulin and reversing existing insulin resistance.
Can all diabetics get the benefits of this new treatment for Diabetes ??? Well, the answer is a little disappointing. Not all diabetics are eligible to undergo this new treatment for Diabetes. This latest diabetes treatment is reserved for type 2 diabetics. But there are certain eligibility criteria to be fulfilled by type 2 diabetics to make them eligible to avail of the benefits of this metabolic surgery ( diabetes surgery).

In the eligible type 2 diabetics, results are astonishing – 95% have reversal (No diabetes) within one to two months after the metabolic surgery (diabetes surgery). Of these, many have diabetes resolution before their discharge i.e within 2 days of their metabolic surgery.

By control of type 2 diabetes, it means that blood sugar levels are maintained within the normal range with the current oral hypoglycaemic agents or insulin that the person is taking during the day. By remission we mean the sugar levels will be maintained within the normal range without the current oral hypoglycaemic agents or insulin that the person was taking before the surgery.

Because of this, after metabolic surgery, the HBA1C tends to get back to normal and thus the chances of long term complications related to type 2 diabetes is reduced in a big way. Also, if a person has been having microalbuminuria, it is seen to reverse within a month of the surgery. Patients experience a lot of relief in the burning sensation they had before the surgery.”

What compromise one may have after undergoing this new treatment for diabetes/ latest treatment for diabetes???
Supplements of multivitamin and calcium are necessary to be taken life long in anyone undergoing metabolic surgery. But this should not be an issue because diabetics are advised to take multivitamins regularly even though they have not undergone the surgery.

Protein supplements are to be taken for 6 months.
To start with, the intake of food will be reduced in quantity which will increase gradually as the stomach pouch stretches. Also as the stomach pouch size is reduced, one feels full with little food.

Is it worth compromising the amount of food intake in metabolic surgery in type 2 diabetics??? 

It is a matter of one thinking. Diabetes is known to cause complications over years. Earlier there was no treatment available by which one could get out of type 2 diabetes. But now, thanks to metabolic surgery, one can get remission from type 2 diabetes and halt the progression of microangiopathy and thus complications. So now, one must weigh the benefits of the surgery Vs the restriction in food intake Vs complication of type 2 diabetes. Complications of metabolic surgery/ diabetes surgery/Can the choice of metabolic surgery be given to patients who have long-standing diabetes for approx 15 to 20 years?

In those who have been suffering from diabetes for many years approx 15 to 20 years and whose C peptide levels and serum insulin levels are not all that good, there is a chance that there may not be complete remission of Type 2 diabetes. In such cases, the number of oral hypoglycaemic tablets decreases and the insulin requirement will stop, but, the patient might have to take an oral hypoglycaemic tablet once a day to keep the sugars in the normal range.

Even this will curtail the progress of type 2 diabetes into complications and thus give a better quality of life.

What is Metabolic syndrome?

Diabetes is a part of metabolic syndrome, When a person has one of the five mentioned below, it is termed metabolic syndrome. Diabetes, Hypertension and Dyslipidemia(a high triglyceride level, reduced HDL cholesterol) or excess body fat around the waist.

When a person undergoes metabolic surgery, the single surgery deals with diabetes, dyslipidemia, excess fat around the waist and one does not have to take separate medication for diabetes, separate medication for dyslipidemia, hypertension etc.

Whatever your current status, here is the point. You can make some decisions today regarding your diabetes health issues that will have repercussions for years to come. The idea is not just to add extra years to your life, but healthy years. If you have type II diabetes, you can get help immediately by visiting the recommended website today: Get information about diabetes Surgery

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Dr. Tulip

Dr. Tulip is an advanced laparoscopic and Bariatric surgeon practicing in Bangalore at TODS- Dr. Tulips Obesity and Diabetes Surgery Centre

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