Metabolic Surgery for people living with Diabetes

Citizen News Service - CNS
Recent guidelines by the International Diabetes Federation (IDF) state that metabolic surgery is a treatment option for any overweight person with a Body Mass Index (BMI = weight in kilograms/ height in metre square) of more than 30 and with co- morbidities like cardiovascular disease risk factors, uncontrolled diabetes, hypertension, hyperlipidaemia and obstructive sleep apnoea.

Diabetes is a chronic disease which progressively damages the body’s organs. Most often, even though sugar levels may be controlled, organ damage may continue. Obese people with a Body Mass Index (BMI = weight in kilograms/ height in metre square) of over 35, with coexisting medical conditions like diabetes, are ideal candidates for metabolic surgery.

According to the American Heart Association, “Surgical intervention leads to significant improvements in decreasing excess weight and co-morbidities that can be maintained over a long period of time.”

Metabolic surgery has been found to reverse diabetes in more than 80% cases. It not only resolves overweight issues, but also frees the patient from a restrictive regime of constant sugar level monitoring, daily dose of insulin injections and possible side-effects of drugs. Metabolic surgery brings about a change in the digestive system: certain hormones are released which favourably affect insulin secretion and insulin resistance, and which alter the way of glucose metabolism in the body. It is generally considered a safe surgery and in-patient time is found to be not more than a single day in most cases.

“Patient compliance with the long-term lifestyle changes is required to maximize success of surgery and minimize complications. … remission of diabetes, even if temporary, will still lead to a reduction in the progression to secondary complications of diabetes (such as retinopathy, neuropathy and nephropathy), which would be an important outcome of … surgery,” as per The Endocrine Society.

Dr Atul NC Peters, Director, Advanced Centre for Weigh Loss & Metabolic Surgery, Fortis C-DOC Centre of Excellence for Diabetes, Metabolic Diseases & Endocrinology calls this a real breakthrough for a person taking insulin shots daily  and living with the fear of all the related complications to be become free of diabetes. He says: “Though bariatric surgery has stood the test of time as a weight loss surgery, until recently, it was considered primarily for weight loss. Recent studies have shown it to be beneficial in type II diabetes as a stand-alone procedure. Few modifications in the surgical techniques have shown to be very effective in resolving diabetes, and in selected patients we have seen close to 80% resolution.”

Dr Anoop Misra, Chairman, Fortis C-DOC Centre of Excellence for Diabetes, Metabolic Diseases & Endocrinology, also agrees that, “In people living with diabetes, who are obese and at risk for multiple complications, bariatric surgery, for the first time, provides the option of a cure for diabetes. It should be discussed with all such patients as a treatment option.”

Citizen News Service - CNS
November 2013 

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