WHAT IS DIABETES?
Diabetes is a disease that occurs due to insufficient secretion or ineffectiveness of the insulin hormone produced in the pancreas, where sugar molecules passing from the intestines to the blood cannot enter the cells and accumulate in the blood. A fasting blood sugar level above 126mg/dl or a postprandial blood sugar level above 200mg/dl is sufficient for the diagnosis of diabetes. Individuals with fasting blood sugar levels of 100-126mg/dl have impaired glucose tolerance and their diabetes status is checked by performing an Oral Glucose Tolerance Test (OGTT). It is broadly classified as Type I and Type II. There are also some intermediate forms of these two types. Type I diabetes usually develops as a result of the destruction of insulin-producing cells after the body's defenses attack the pancreatic tissue as an autoimmune disease following some infectious diseases in childhood or adolescence. Insulin is used for life in its treatment. Type II diabetes usually occurs in obese individuals in adulthood. Due to excess fat in the cells, there is resistance to insulin at the cellular level, and although insulin is secreted from the pancreas, it does not work. Since not enough sugar fuel enters the cells, they cannot produce energy and do not fulfill their duties fully. Excess sugar accumulated in the blood is tried to be excreted by the kidneys. Kidneys, eyes, nerves, vessels and various tissues and organs are affected by high blood sugar and begin to deteriorate over time. Various tablets and insulin are used together with diet in the treatment of type II diabetes. Patients can also get rid of diabetes because insulin resistance decreases when they lose weight.
SURGICAL TREATMENTS USED IN THE TREATMENT OF TYPE II DIABETES
Type II diabetes (diabetes mellitus). One of the reasons why it is rapidly increasing as a serious epidemic in the world today is the western diet. With this diet, high-calorie refined foods are used. This diet, combined with inactivity, increases the tendency for obesity and diabetes. GLP-1 and some similar hormones are secreted from the last part of the small intestine, called the ileum. The release of these hormones increases significantly as food reaches this region, but Since affine foods are almost completely absorbed in the part of the intestines close to the stomach, insulin resistance occurs because these hormones, which act as the opposite of insulin, are not activated with today's diet.
TRANSIT BIPARTATION
Transit Bipartition surgery is performed on the patient after the gastric sleeve surgery is performed, and at the same time, the part of the ileum close to the large intestine is cut and the lower part is transferred to the stomach and the upper part to this intestine. It is the general name of the process of connecting the stomach connection in a Y shape after certain lengths.
SASİ (SINGLE ANASTOMOSIS SLEEVE WITHLEAL BY-PASS)
SASİ surgery is a different version of the Transit Bipartition procedure. A single intestinal connection is made to the stomach.
ILLEAL INTERPOSITION
In ileal interposition surgery, the small intestine called ileum is brought closer to the stomach as a whole, allowing intestinal hormones to become activated early. There are two different types: diverted and non-diverted. In the diverted type, the ileum is connected to the stomach, and in the non-diverted type, it is placed between the part of the intestine close to the stomach called jejunum. The difference from TB is that there is no disabled part of the intestine that causes malabsorption.
JEJUNOILEAL BY-PASS
In jejunoileal by-pass surgery, the stomach is turned into a tube and the intestine close to the stomach called jejunum is separated from the intestine close to the large intestine called ileum. An anastomosis, that is, an intermediate connection, is created to exclude a part of the intestine from absorption. In this way, the absorption of food decreases and ileum hormones become activated.
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