Diabetic Surgery

Diabetes is a condition that can result from unhealthy eating habits, a sedentary lifestyle, or hereditary factors. In type 1 diabetes, there is no insulin production, while in type 2 diabetes, insulin is produced but the body cannot effectively utilize it, leading to persistently high blood sugar levels and potential organ damage. The conventional approach to treating diabetes focuses on lowering blood sugar levels. However, diabetes surgery, also known as metabolic surgery, is an effective therapeutic option. It is primarily performed on patients with type 2 diabetes and aims to improve insulin utilization within the body.

What is the purpose of diabetes surgery?

The main objective of diabetes surgery is to reduce insulin resistance and increase hormone levels. While insulin therapy is the standard treatment for type 1 diabetes, surgery becomes necessary for type 2 diabetes patients who are experiencing organ damage despite lifestyle modifications, dietary changes, and medication use. Diabetes surgery is typically performed using a minimally invasive approach, involving the removal of approximately 50% of the stomach and the repositioning of the small intestine. These significant alterations stimulate insulin secretion from the pancreas and greatly enhance its effectiveness. As a result, type 2 diabetes is resolved, and patients often experience weight loss as a beneficial side effect. Compared to open surgeries, this procedure is less painful, poses a lower risk of lung complications, and allows for a shorter recovery period.

Why should I consider diabetes surgery?

For individuals who are overweight or obese but not severely obese, adopting a healthy lifestyle and engaging in physical activity are generally the recommended methods for reducing health risks and weight. However, individuals who are morbidly obese or have type 2 diabetes and at least one comorbidity face a significantly higher risk of worsening health conditions or premature death. Non-surgical interventions, such as dietary changes, exercise programs, medications, and social support, often yield limited success in treating severe obesity, with relapse rates reaching up to 90% regardless of the approach used. While temporary weight loss may be achieved with various methods, sustaining that weight loss can be challenging. Given that severe obesity is a chronic condition that is difficult to address solely through diet and exercise, surgical interventions become crucial options for individuals unable to lose weight with conventional methods or those with severe type 2 diabetes. For severely obese patients with elevated blood sugar levels or pre-diabetes, diabetes surgery can significantly reduce or even eliminate the risk of developing type 2 diabetes.

How is diabetes surgery performed?

Diabetes surgery can be performed using different techniques, which may vary based on the individual’s condition. In cases where patients are overweight, bariatric surgery is preferred over metabolic surgery. If diabetes is the underlying cause of metabolic issues, either ileal interposition or transit bipartition procedures are typically chosen. While both procedures have similar techniques, their mechanisms of action are distinct. In the ileal interposition procedure, emphasis is placed on increasing insulin secretion by enhancing the contact of a specific intestinal segment with food. The part responsible for suppressing insulin is relocated to the end of the intestines. In the transit bipartition procedure, the intestinal flow pattern is altered to facilitate faster digestion of food. This leads to a higher rate of insulin secretion while minimizing the risk of vitamin and mineral deficiencies.

Can type 1 diabetes patients undergo surgery?

Since type 1 diabetics have a lack of insulin production in their bodies, surgery is not suitable for this type of diabetes. For patients with type 2 diabetes, where the goal of surgery is to ensure proper and adequate insulin usage, the decision-making process for surgery begins when the disease progresses and organ damage occurs. A thorough evaluation, including various tests and examinations, is conducted before proceeding with any operation. While all surgeries carry risks, in certain cases where conventional methods fail to achieve success, surgery may be the only viable solution.

What should be done after diabetes surgery?

Following diabetes surgery, the feeling of hunger will occur less frequently. Patients will feel full for extended periods after consuming smaller meals, as insulin secretion matches the body’s needs after eating, reducing appetite. Normal eating habits will gradually resume, and patients will experience an overall improvement in their well-being. It is recommended to consume 1.5-2 liters of water daily after the procedure, as adequate water intake is crucial. The doctor will closely monitor and control the patient’s nutritional habits for 6 months to 1 year post-surgery, intervening promptly if any minimal vitamin deficiencies are observed. Therefore, diabetes surgery provides an excellent form of treatment for individuals with diabetes.

Benefits of diabetes surgery

The benefits of diabetes surgery include:

– Promoting remission of diabetes, leading to normalized blood sugar levels without medication.

– Significant regulation of blood sugar levels.

– Helping control diabetes and achieve weight loss.

– Treating metabolic disorders like high blood pressure, hyperlipidemia, and sleep apnea.

– Substantially reducing the incidence of cancer.

– Increasing lifespan.

Risks of diabetes surgery

The extent to which type 2 diabetes has progressed and the resulting organ damage must be carefully evaluated. A thorough understanding of patients’ medical history and current condition is essential. Diabetes surgery is considered a last resort, as type 2 diabetes involves multiple metabolic issues. However, not all patients may be suitable candidates for ileal interposition or transit bipartition surgery, as eligibility depends on various factors. While the risk of death associated with diabetes surgery is low, it should be noted that the presence of obesity, diabetes, and other comorbidities significantly increases the overall risk of harm or death. Diabetes surgery carries similar risks to those of normal digestive system surgeries. Anesthesia, which is commonly used in all surgical procedures, can have some negative effects. Additionally, although rare, complications such as infection and abscess formation may occur. It is important to highlight that these risks are minimal, accounting for only 3% of cases, which is relatively low for surgical operations. Moreover, as medical technology continues to advance, these risks are progressively diminishing. Patients who opt for diabetes surgery undergo meticulous monitoring and comprehensive control of their blood values for a specific period. This enables surgeons to calculate and minimize potential risks, side effects, and complications during the operation. As a result, the occurrence of possible risks associated with diabetes surgery is minimized, often leading to minimal complications.