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Diabetic Surgery

Diabetes has reached epidemic proposition and almost 90% of type 2 diabetes persons are obese. Weight loss helps to reduce diabetes by almost 50%. There are some people who are just overweight or also normal weight but severely diabetics.

Type 2 Diabetes and Its Effect

  • Its chronic disease with injurious effects on all parts of body
  • Once diabetic , always a diabetic
  • It can cause renal disease, blindness, diabetic foot, increased incidence of silent heart attacks and many more problems
  • Treatment consists of life style modification, medication and weight loss
  • In spite of adequate medications, people may require insulin and oral medications
  • Medications can control not cure diabetes

Diabetes and Its Causes

  • Obesity cause decrease insulin production
  • Obesity causes insulin resistance
  • Anti insulin products causes high blood sugars
  • Less GLP causes in diabetics causes raised blood sugars
  • Increased fat results in less adiponectin and more leptin which results in high sugars

How laparoscopic surgery does helps to cure type 2 Diabetes?

  • Reduction of weight in obese people
  • Reduction of anti insulin products
  • Increased GLP production
  • Insulin sensitization or increased production

All these mechanisms are going to help to reduce blood sugar which will help to cure diabetes in 80% of patients and improves diabetes in remaining patients.

Procedures:

procedures are chosen depending on whether a person is suffering from diabetes with normal weight or diabetes is associated with overweight.

  • These procedures are done laparoscopically
  • Its indicated in type 2 diabetes only
  • People with diabetes history of less than 10 years respond well
  • Not indicated in type 1 diabetes

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PROCEDURE

Sleeve gastrectomy with ileal transposition

  • Here first stomach size is reduced to very small capacity by vertical stapled gastrectomy. The ileum, terminal part of small intestine of about 50 – 70 cm segment is transected and interposed in proximal part of intestine. This leads to early exposure of food to ileum resulting in rise of GLP which reduces sugar levels and causes permanent remission of diabetes.

HOW PERSON BENEFITS

  • Almost 80% of patients would no longer require insulin or medications
  • Almost all patients who are on insulin will no longer require insulin
  • Those who still require medication may need minimal dose
  • Diabetes related complications like nephropathy gets better
  • Patients can eat their favorite food.

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