Metabolic Surgery for Type 2 Diabetes

Metabolic Surgery for Type 2 Diabetes

Among the diabetics, about 90 % are suffering from Type 2 Diabetes Mellitus. In this form, either the body does not produce enough of the hormone insulin, or the cells in the body do not use insulin properly. Complications of diabetes include heart disease, blindness, nerve damage and kidney damage.

This type 2 diabetes is most closely linked to obesity.

Treatment:

Lifestyle changes, which  include losing excess weight or eating a healthful diet and engaging in regular exercise are the first-line treatments for type 2 diabetes. When these do not work we need to prescribe certain medicines. Some medications help the pancreas produce more insulin, while others help the body use the insulin that it does produce more efficiently. If these medicines don't work, a person may need to take insulin.

These  treatments for diabetes do not work most often and patients run the risks of certain long term complications. These include:

Diabetic Retinopathy – the leading cause of blindness in adults.
Diabetic Nephropathy – the leading cause of kidney failure in adults.
Diabetic Neuropathy – leading cause of non-traumatic amputations of the lower extremities in adults.
Cardiovascular disease – 8/10 patients with type 2 diabetes die of cardiovascular disease.
Stroke – 2 to 4 times more likely to have a stroke.
 Metabolic Surgery for Diabetes- a possible cure?

Yes!

The aim is to put it in remission so that there is no need for diabetes medication. This means bringing glucose to normal levels and arresting the progression of the diabetic complications, thus giving the body a chance to repair the damage.

A landmark 2004 study of more than 22,000 people who underwent bariatric surgery showed the following:

Diabetes was completely resolved or improved in 86% of patients.
High blood lipids improved in 70% or more of patients.
High blood pressure was resolved or improved in 78% of patients.

What's more, a study in the Annals of Surgery showed that 83 percent of 240 people who underwent gastric bypass were "cured" of their diabetes.

A study in the New England Journal of Medicine found that long-term mortality after gastric bypass surgery was significantly reduced, particularly deaths from diabetes.

The bottom line is that metabolic surgery can play a big role in treating Type 2 diabetes.

How Does Metabolic Surgery Work ?

Early bypass of food to  lower intestine stimulates production of  a substance called glucagon-like peptide 1 (GLP-1) , which can increase insulin production as well as decrease glucagon secretion and increases the efficiency of insulin.

Now the question that remains is when, should the surgery be performed — when diabetes is first diagnosed or, when complications have already begun to arise?

Ideally, the sooner the better to prevent the complications of type 2 diabetes.

How about type 2 diabetic patients who are not obese?

Metabolic surgery also benefit even people with diabetes who are not overweight or obese. Procedures such asIleal  interposition and Duodenojejunal Bypass are designed to have metabolic benefits without weight loss