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June 7, 2024 In Diabetes By Dr. Vikas Singhal

Type 2 Diabetes Surgery: Indications, Tests, Treatments & Cost

Diabetes type 2 is a chronic illness that affects millions of people worldwide. Even though medication and lifestyle modifications are popular diabetes treatment techniques, some people may need “Diabetes Surgery” to properly control their diabetes. This blog examines whether surgery is indicated, what tests are required, what therapies are available, and how much these operations will cost.

Understanding Type 2 Diabetes

Insulin resistance and decreased generation of insulin are the hallmarks of type 2 diabetes, a chronic illness. In contrast to type 1 diabetes, which is caused by the immune system attacking cells that produce insulin, type 2 diabetes is frequently linked to lifestyle choices including being overweight, eating poorly, and not exercising. Genetics is also a major factor.

Insulin is a hormone that controls blood sugar levels, and type 2 diabetes occurs when the body’s cells grow resistant to it. Consequently, elevated blood sugar levels are caused by the accumulation of glucose in the circulation. Serious side effects over time might include kidney damage, nerve harm, heart disease, and visual issues.

Increased thirst, frequent urination, exhaustion, impaired vision, and slowly healing wounds are some of the signs and symptoms of type 2 diabetes. A good diet, consistent exercise, weight loss, insulin injections, and medicines to increase insulin sensitivity are common lifestyle modifications used in management. In extreme situations, surgical procedures including bariatric surgery can help lower the risks of type 2 diabetes and improve blood sugar management.

Indications for Type 2 Diabetes Surgery

  • When medicine and lifestyle modifications fail to regulate a patient’s blood sugar, surgical treatments are frequently explored.
  • Patients with extreme obesity (BMI above 35) and associated comorbidities including neuropathy, renal impairment, or cardiovascular problems may benefit most from these operations.
  • Another important sign that surgery should be considered is insulin resistance which is unresponsive to conventional forms of therapy.

In the end, surgery becomes a possible choice if non-conventional therapies are unable to control the illness.

Pre-Surgery Tests and Evaluations

To make sure the patient is suitable for the treatment, some tests and assessments are necessary before the surgery is performed.

  • Blood tests: Used to assess liver and kidney function, cholesterol, blood glucose, and HbA1c.
  • Cardiovascular Assessment: To guarantee that the heart is robust enough to withstand operation.
  • Nutritional Assessment: To assess one’s nutritional state and eating habits.
  • Psychological evaluation: To gauge the patient’s level of mental preparedness and make sure they are aware of the lifestyle modifications needed after surgery.
  • Imaging tests: MRIs, ultrasounds, and X-rays to evaluate internal organs and find any issues.

Surgical Treatments for Type 2 Diabetes

  • Gastric Bypass 
    • Gastrectomy is one of the most popular surgeries used to treat type 2 diabetes. The small intestine is altered to connect to both the bigger lower remnant and the smaller upper pouch that results from this procedure. Because of this reorganization, the stomach’s capacity is greatly reduced, which results in less food being consumed and improved blood sugar regulation. Patients usually lose a significant amount of weight, which helps with overall diabetes control and better insulin sensitivity.
  • Sleeve Gastrectomy
    • With a sleeve gastrectomy, the stomach is removed in around 80% of cases, leaving behind a tube-like structure. This procedure improves blood sugar regulation and decreases the hunger hormone, ghrelin, in the body. This technique results in weight loss, which helps to improve type 2 diabetes control. Sleeve gastrectomy causes fewer nutritional deficits than gastric bypass, although surgery still necessitates lifetime dietary changes and supplements.
  • Gastric Banding
    • A less invasive procedure called gastric banding involves creating a little pouch around the top portion of the stomach by placing an adjustable band around it. Because it is reversible and adaptable, this surgery offers patients a flexible choice, which makes it distinctive. It lowers blood sugar levels by limiting food intake, which aids in weight reduction. Nevertheless, there is a chance of band erosion or slippage, and the long-term efficacy of gastric banding is sometimes less than that of other treatments.
  • Duodenal Switch with Biliopancreatic Diversion (BPD/DS)
    • A considerable section of the small intestine is bypassed in BPD/DS in addition to a sleeve gastrectomy. For patients with extreme obesity, this intricate procedure is quite successful and improves diabetes management significantly. It results in significant weight reduction and improved insulin sensitivity by decreasing the size of the stomach and restricting the absorption of foods. However, there is a greater danger of nutritional deficits and a more involved surgical procedure.
  • Ileal Transposition
    • A less common technique called ileal transposition involves moving a section of the ileum—the final segment of the small intestine—closer to the stomach. The goal of this procedure is to boost hormone synthesis, which enhances glucose metabolism and insulin sensitivity. Although it shows promise, it is still in the experimental stage and not readily accessible.

Cost Of Different Type 2 Diabetes Surgeries

The kind of operation, surgical intricacy, hospital location, and surgeon experience all affect how much different diabetes type 2 procedures cost.

Surgery Approximate Cost (INR)
Gastric Bypass Surgery 3,00,000 – 5,00,000
Sleeve Gastrectomy 2,50,000 – 4,50,000
Gastric Banding 2,00,000 – 3,50,000
Biliopancreatic Diversion (BPD/DS) 3,50,000 – 6,00,000
Ileal Transposition 4,00,000 – 7,00,000 (if available)

Post-Surgery Care and Lifestyle Changes

Patients must significantly modify their lifestyles following surgery to guarantee the procedure’s effectiveness.

  • Dietary modifications: include eating small, frequent meals that emphasize nutrient-dense foods.
  • Consistent Exercise: Crucial for sustaining weight reduction and enhancing general health.
  • Regular Monitoring: Routine examinations to track nutritional status and blood sugar levels.
  • Supplements: They could be required to prevent deficits, particularly following malabsorptive treatments.
  • Support Teams: psychological assistance to help sustain long-term success and help adapt to changes in lifestyle.


For those with type 2 diabetes who find it difficult to control their disease using traditional means, surgery is a viable option. Surgical procedures can greatly enhance general health and blood sugar regulation. Benefits, risks, and expenses associated with any procedure should be thoroughly evaluated. Making an informed choice requires an understanding of the complete cost breakdown, which includes pre-surgery testing and post-surgery care. Ultimately, patients can enhance their quality of life and better control their diabetes with the appropriate surgical care and lifestyle modifications.

Contact Dr. Vikas Singhal, the best bariatric surgeon India, today to learn more about your options and take the first step towards a healthier future.

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