The logic of metabolic surgery is that displacement or bypass methods in the intestinal system shorten the intestine. The most important feature of diabetes surgeries is increasing the secretion of the hormone called GLP-1 (increases insulin production cells in the pancreas) from the small intestines. It is used by diabetic patients to regulate diabetes by producing the GLP-1 hormone as a medicine, but it never shows the regulatory effect of diabetes surgery.
The difference between diabetes surgery and obesity surgery is that the small intestine is bypassed, that is, it must be disabled. Combined surgery is performed in all diabetes surgeries. By both sleeve gastrectomy (stomach reduction) and shortening or changing the direction of the intestines, absorption disorders are improved and hormone levels increase as a result of the meeting of nutrients with the last part of the small intestine. Thus, in the treatment of diabetes, it provides both absorption from the stomach and absorption in all procedures of the intestine. Since diabetes surgery is performed using the laparoscopic surgery method, the pain is felt less and the recovery process is faster. Diabetes surgery solves both the problem of obesity and diabetes.
Thanks to this operation, the person gets rid of diabetes, excess weight, and the effects of the metabolic syndrome caused by this weight over time.
Diabetes. Relationship Between Disease and Obesity
Insulin resistance due to excess weight develops in people in the obesity group. The biggest problem in type 2 diabetic patients is insulin resistance. People who develop insulin resistance require much more insulin than normally needed to regulate blood sugar levels. People with insulin resistance cannot regulate blood sugar because the insulin secreted from the pancreas in normal amounts is insufficient in response to this resistance. As a person's weight increases, the level of insulin resistance in the blood increases and the pancreas tries to compensate for this situation by working harder. Accordingly, blood insulin levels of overweight people are generally high.
After a certain stage, the person's diabetes improves. It may be necessary to use external anti-diabetic drugs or insulin to relieve it. High levels of insulin in the body stimulate the hunger center, causing the person to become hungry more frequently, eat more than usual, and become overweight. It is very difficult for these people to comply with diet programs, lose permanent weight, and control their weight and sugar. Because this type of diabetic patients are in a very difficult vicious circle.
Why is Surgery Effective in the Treatment of Diabetes?
In diabetes surgery, first of all, gastric sleeve (stomach reduction) surgery is performed on the patient and the food is consumed 2 times. 1/3 of it is allowed to reach the last 200 cm of the small intestines, and 1/3 of it is allowed to pass through the duodenum (natural route). Foods that reach the last part of the intestines initiate the release of insulin from the pancreas under the influence of the hormones in this area. Patients will no longer have to buy external diabetes medication or use injections because they will be able to use the insulin secreted from their own bodies thanks to this operation.
Who is it for and what are the conditions? Am I Suitable for Surgery?
Type 2 diabetic patients whose insulin reserves are not exhausted can have this surgery. The most important condition for successful diabetes surgery is that the person's pancreas produces insulin, even to a small extent. Therefore, people considering diabetes surgery should apply to the necessary institutions before their reserves run out. All diabetes surgery methods (ileal interposition, gastric by-pass, transit bipartition) can be applied between the ages of 18 and 65.
Since patients will lose weight after this surgery, they are required to be above a certain BMI rate. It is also a great solution for the co-morbidities caused by obesity (hypertension, diabetes, sleep apnea, etc.) for patients with a BMI (body mass index) value over 30. Patients with a BMI (body mass index) of 40, that is, morbidly obese (overweight) patients, are much more affected by the co-morbidities caused by obesity. It is recommended that these patients undergo obesity and metabolic surgery operations without any damage to the body.
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