Is it possible to treat diabetes with surgery?
Yes, it is possible to treat type 2 diabetes, that is, diabetes that is acquired rather than congenital, with surgery. The treatment method of diabetes is slowly changing towards surgical treatment.
How did this treatment method come about?
We can say that obesity surgeries are actually the ancestors of this treatment. After gastric bypass surgery for obesity, we saw that the blood sugar level improved before the patient was discharged, the patients stopped insulin and their diabetes complaints disappeared.
What is surgery (metabolic surgery) and how does it cure diabetes?
There are actually several types of metabolic surgery, but the common feature of all of them is that the stomach is reduced in size and the small intestines are connected to this reduced stomach at various levels. Stomach reduction is necessary to prevent the patient from gaining or even losing weight. It reduces appetite. Foods that pass into the small intestines earlier than normal also contribute to the recovery of diabetes by stimulating the secretion of many hormones from the intestines that help us control blood sugar. There are many types of surgeries such as gastric bypasses, transit bipartitions, etc., but this is the basic logic. We decide which surgery will be performed on which patient after a series of examinations. Does the patient have gastric reflux? Is it necessary to lose weight? Many factors such as whether there is a osteoporosis problem guide us in determining the type of surgery. At this point, the surgeon's duty is to master all types of surgery and to perform the appropriate surgery for the appropriate patient.
Which patients are suitable for surgery (metabolic surgery)?
First of all, it must be said that they have type 2 diabetes, which is a very frequently asked question. One of the questions is whether it is beneficial in type 1 diabetes. No, no. In addition, the patient's insulin reserve must be sufficient. We said that these surgeries enable us to use the insulin in the body more efficiently, but for this, insulin secretion in the body must continue. Because in the early stages of diabetes, our pancreas gland works overtime and secretes too much insulin, but there is resistance to these insulins and they cannot lower blood sugar enough. In the advanced stages of diabetes, the pancreas becomes exhausted. It stops producing insulin, which is beneficial if metabolic surgery is performed before insulin production ends. We perform a series of blood tests to determine whether the pancreas is working or not, and we can predict whether the patient will benefit from this surgery or not in the preoperative period.
What are the risks of the surgery, is it a risky surgery?
There is no surgery without risks anyway. Each surgery has its own risks, but if you are asking whether this surgery is high risk, my answer is no. Leaks that may occur in the gastrointestinal connections are the most feared complications. But we have to say that uncontrolled diabetes itself basically damages every tissue because it damages the vessels. It causes eye damage, impairs wound healing, non-healing wounds appear on the feet, causes kidney damage, impairs sexual functions, increases the risk of heart attack, and has many other harms that I cannot think of right now. In other words: uncontrolled diabetes is much more dangerous than this surgery.
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