Diabetes Surgery

Type 2 diabetes; occurs when the body does not produce enough insulin or does not use the insulin it produces effectively and is called a chronic metabolic disorder. This is known as insulin resistance.

In cases where it is not treated; Apart from the heart, eyes, kidneys, it will adversely affect various organs and tissues. It eventually leads to high blood sugar or undesirable sugar levels.

In addition to drug therapy, diabetes surgery is one of the solutions for patients to lose weight and to control Type 2 diabetes safely and effectively.

Is There a Link Between Type 2 Diabetes and Obesity?

Diabetes, which is defined as high blood sugar, is called a metabolic disorder. The body uses the digested food for growth and energy. If this is not taken under control, the quality of life decreases, and diabetes begins to affect life.

According to this;

  • type 2 diabetes; causes results such as eye disorder, blindness, heart disease, stroke, kidney failure, amputation, nerve damage, heart attack at an early age.
  • An average of 80% of people with type 2 diabetes are overweight or obese.
  • Overweight; is the way to define obesity and morbid obesity. A person should have an average body mass index (BMI) of 25.
  • People with a body mass index of 0 or higher are defined as morbidly obese.

By looking at these definitions, it is understood whether people are obese or morbidly obese and whether they will develop diabetes 2.

How Is Type 2 Diabetes Diagnosed?

type 2 diabetes; is a sign of high blood sugar, as the body cannot produce enough insulin. As a result, insulin resistance occurs. Type 2 diabetes is a disease characterized by impaired insulin production.

This means an increase in the need for the drug; permanent and worsening glycemic control, stroke, kidney failure, eye diseases, heart attack, diabetes complications such as blindness.

Type 2 diabetes is closely associated with cardio-metabolic disordersAccording to this;

  • Hypertension;
  • obesity and
  • It is linked to increased blood cholesterol and triglycerides.

Although the problems under type 2 diabetes are not yet fully understood, obesity, wrong diet, lack of physical activity, advancing age, insulin resistance, family history of diabetes, and ethnicity constitute many risk factors.

Why Is Type 2 Diabetes Dangerous?

Obesity and type 2 diabetes are one of the most important problems affecting the metabolism of the human body and are closely related to each other. Changes that will occur due to weight loss after surgery cause remission on type 2 diabetes.

In other words, the end of the symptoms on chronic diseases or the situation of not showing the symptoms even though the treatment continues. People with diabetes or obesity; need to know that they can regain the body’s ability to use sugar in a healthy way with surgery.

Considering these conditions, type 2 diabetes;

  • One in 10 deaths worldwide is due to diabetes.
  • People with diabetes; are more prone to heart disease, kidney failure, blindness, stroke.
  • 90% of type 2 diabetes is caused by obesity and being overweight.

Diabetes surgery; is the most effective treatment for type 2 diabetes. Bariatric surgery is also recommended for patients with type 2 diabetes and mild obesity. Diabetes surgery; is much safer, as it has a much lower percentage of complications than common procedures such as knee replacement and gallbladder surgery.

Who is a Candidate for Type 2 Diabetes?

If you have type 2 diabetes, if you have a body mass index of 30 and above, you may prefer surgical diabetes treatment. 

Type 2 diabetes candidate among other qualifications;

  • Those with a body mass index of 40 and above;
  • In addition to body mass index 35 and type 2 diabetes; those with hypertension, sleep apnea, and respiratory disorders, at least 1 or more obesity-related comorbidities such as lipid abnormalities, gastrointestinal disorder, heart disease;
  • Those who cannot lose weight in a healthy way despite their efforts to lose weight may be candidates for bariatric surgery.

The decision to undergo surgery is a completely individual decision. However, the treatment of diabetes and whether the surgery decision is correct is determined by the doctor.

How Is Diabetes Diagnosed?

Diabetes is done in children and adults who are not pregnant. For this, a fasting blood sugar test is performed. However, this test is not sufficient for diagnosis. Other tests also need to be done.

Tests other than fasting blood sugar test;

  • Oral glucose tolerance test: After drinking a beverage containing 75 g glucose dissolved in water, after 2 hours, it is checked whether the blood sugar level is 200 mg/dl or higher.
  • High blood sugar level measurement: It is a measurement of a blood sugar level of 200 mg/dL or higher to be taken at any time of the day, at random, with the appearance of diabetes symptoms.

Fasting blood sugar test, oral glucose tolerance test is performed, the sugar level in the blood is measured and it is determined whether there is diabetes or not.

What Types of Surgery Are Performed in Diabetes?

Different types of surgery are preferred in the treatment of diabetes. You can consider surgery as one of the most effective types of surgery on type 2 diabetes.

  • Gastric bypass (roux-en y gastric bypass): It is performed by changing the gastrointestinal tract. Type 2 diabetes remission and recovery are achieved with a rate of 15%.
  • Sleeve gastrectomy (sleeve): It is the removal of a part of the tube stomach. The remaining stomach narrows and food accumulates in one less chamber. Improvement is seen in 60% of patients.
  • Biliopancreatic diversion with duodenal switch (Duodenal switch): Less common than other procedures. It is not very common as it is a complex procedure. Apart from weight loss, 85% improvement is achieved.
  • Single anastomosis duodenal-ileal bypass with sleeve gastrectomy (Sadı-S): It is the procedure of turning the stomach into a tube as in sleeve gastrectomy surgery. It shows weight loss and remission in type 2 diabetes.

Post-operative risks

As with any type of surgery, there are risks in type 2 diabetes surgical procedures. But bariatric surgery carries fewer risks than other surgical procedures. All risks are explained to you by your doctor before the operation.

What are the Benefits of Metabolic and Diabetes Surgery?

The benefits that may occur after type 2 diabetes surgery in people with high obesity also increase the person’s quality of life and desire to live.

After metabolic surgery;

  • Blood sugar levels return to normal, without the use of medication, and remission is encouraged.
  • Blood sugar levels are kept under control with less medication.
  • Metabolic disorders such as hyperlipidemia, sleep apnea, and hypertension begin to improve.
  • The incidence of cancer shows a decrease.
  • Long-term survival is increased.

Is Type 2 Diabetes Surgery Suitable for You?

Many patients; In cases where diabetes cannot be controlled as a result of medication, healthy diet, and lifestyle changes, it focuses on metabolic surgery, which is defined as diabetes surgery.

After the diabetes surgery is performed; It gives very good results in people who are above the ideal weight, who have short-term diabetes, and in diseases such as kidney/heart. However, on type 1 diabetes; These surgeries have no effect on the pancreas not working at all or the formation of antibodies against insulin.

Metabolic surgery application ;

Thanks to these surgeries, 85% to 90% of diabetes patients were treated and people were able to get rid of this disease. The procedures performed are performed under general anesthesia and the patient stays in the hospital for 4 days.

According to this; If your body mass index is much higher than normal and you cannot lose weight despite all your efforts and your diabetes is progressing, bariatric surgery and metabolic surgery are suitable for you.

When Should Surgery Be Considered?

Metabolic surgery can be considered if you have difficulty losing weight despite trying all weight loss methods with diet or exercise, and if you have a body mass index of 40 and above.

By reviewing your surgical options; You can consult your doctor whether surgical options are suitable for you and you can make the right decision about the treatment of your disease in accordance with your doctor’s recommendations.