Can a Surgery Treat Diabetes?

With the twin epidemiology of type 2 diabetes and obesity on the rise, it has become difficult to treat type 2 diabetes mellitus (T2DM) and its associated complications. According to WHO, obesity and diabetes over the last decade has become a global problem. According to evidence based research studies Asians are found to have a higher incidence rate of diabetes, due to their food habits and genetics. Some major complications of Diabetes include:

• Heart attack
• Stroke
• Chronic Kidney disease or Kidney failure,
• Damage to the nerve causing digestive and bladder problems. 
• Diabetic Foot
• Diabetic retinopathy which can even lead to blindness. 

Bariatric Surgery is approved as a preferred treatment for diabetes by the International Diabetic federation. Bariatric surgery has found to be beneficial in the long lasting remission of diabetes; control of other associated illnesses and cost effectiveness.

Can a surgery treat Type 2 Diabetes?

Before understanding whether a surgery can treat type 2 diabetes or not, it is essential to know how diabetes occurs and what are the causes behind it by a good diabetologist in delhi. 

Type 2 Diabetes is the result of

• Insulin resistance where the insulin cells become resistant due to higher quantities of food consumed. 
• Decreased secretion of insulin from pancreatic cells
• Fatty liver disease.

How Bariatric surgery can help?

Insulin production in the body is driven by the Glucagon like peptide-1 hormone released from the ileum and colon of the small intestine. It has been found that by increasing the levels of this hormone in the gut, diabetes can be controlled. 

Apart from GLP-1 there are various other neurohormonal gut mechanisms all of which work in favour to control diabetes. Keyhole surgery like bariatric surgery is a minimally invasive procedure in which the stomach size is reduced or brought down to avoid the excessive food intake by an individual. 

Benefits of undergoing Bariatric surgery for diabetes.

• Gastric emptying is accelerated
• Helps in bringing partially digested food into the small intestine rapidly
• Increased levels of GLP1 and insulin levels.
• Controlled blood sugar levels
• Reduced weight loss

Bariatric surgery or Diabetes surgery in delhi improves insulin performance and provides a long standing aim for diabetes.

What are the different types of keyhole surgeries?

1. 1. Laparoscopic Sleeve Gastrectomy: In this type of surgery, around 70- 75% of the stomach is excised and 25-30 % is left leaving behind a narrow gastric “tube” also referred as “sleeve”. 
   2. Laparoscopic Gastric Banding: It is a laparoscopic minimally invasive surgery, where the gastroenterologist makes small incisions in the upper abdomen. After which, the surgeon apples an adjustable band around the upper part of the stomach.
   3. Gastric Bypass: It is a type of weight-loss surgery in which the surgeon creates a small pouch from the stomach and connects it directly to the small intestine. This bypasses most of the stomach part and a section of your small intestine.
   4. Modified sleeve gastrectomy & Ileal Interposition: In this surgery, the size of the stomach is reduced with sleeve gastrectomy procedure plus some part of distal or final segment of small intestine is brought towards the duodenum part of the small intestine

It should be noted that, patients who are obese require modified sleeve gastrectomy alone. But patients who are non-obese with diabetes may require sleeve gastrectomy along with ileal interposition.

When is Bariatric surgery considered to be feasible?

Bariatric or key hole surgeries are proved to be beneficial in diabetic patients whose:

• Pancreas are capable of producing good level of insulin hormone
• Diabetic condition is still new and has been suffering from it for past few years or few months

Not suitable in patients

• Who are suffering from diabetes since a very long period and have damaged there organs.
• Not suitable in patients with type 1 diabetes 

What data suggests?

According to data, almost 85% to 90% of diabetic patients are found to be cured by opting these bariatric surgery procedures. While the rest 10-15% have found to consume less medications. Along with diabetic control, other benefits include weight loss, decreased cholesterol level, sleep apnea, cardiac disease, joint pains, hypertension, cancer risk, infertility & mortality (early death).

Bariatric surgery, its procedures and its time:

Bariatric surgical procedures are carried out under general anesthesia. It is a minimally invasive laparoscopic surgery that utilizes instruments like staplers and harmonic scalpel. After the surgery the patient will be kept under observation for 4-5 days in the hospital.