Diabetes Surgery Offers Freedom From Daily Needle Pricks, Insulin Injections And Lifelong Medications

Diabetes Surgery leads to hormonal changes that make the patient’s insulin becomes effective. It is usually considered in poorly controlled diabetics.

India has the second largest adult diabetes population in the world. Over the past three decades, the country has seen a 150 per cent increase in diabetes cases, the Indian Council of Medical Research (ICMR) had stated in its guidelines for people diagnosed with type-1 diabetes, which was released this year in June. The apex medical research body had also highlighted the increasing prevalence of type 2 diabetes among the younger age group of 25-34 years. Lifestyle changes, including a healthy diet and regular exercise, are often advised for optimal management of the diabetes. Since the last few years, endocrinologists are also considering surgical correction of diabetes, popularly called diabetes surgery, especially for poorly controlled diabetics.

Wockhardt Hospital, Mumbai Central recently launched a Diabetes Surgery Clinic to provide better therapeutic care to the diabetes patients in the country. Talking about the efficacy of diabetes surgery, Dr Ramen Goel, Consultant Bariatric and Metabolic Surgeon, Wockhardt Hospital, says that it offers diabetes patients freedom from painful daily needle pricks, insulin injections and lifelong medications.

“Diabetes surgery is an effective treatment option for diabetes – almost all patients will either go into remission or will become well-controlled diabetics,” says the expert.

In an exclusive interaction with the Healthsite, Dr Goel sheds more light on Diabetes Surgery. Given below are excerpts from the conversation:

Why is diabetes called a lifelong disease?

Diabetes is called ‘Rajrog’ or a lifetime disease for a reason. One of the most dreaded illness, diabetes limits person’s ability to lead a normal life, with dietary restrictions and requirement of time bound medicine consumption, regular blood sugar testing, etc.

Many people don’t know about diabetes surgery. Enlighten us on how this treatment works?

Surgical correction of diabetes is now almost two decades old, and it is an accepted treatment option. This usually results in discontinuation of diabetes medicines within a week of surgery. Done through a keyhole/laparoscopic route in 30-40 minutes, majority of the diabetes patients can look forward to a healthy and carefree life gaining freedom from daily needle pricks for blood testing and/or insulin injections.

It is now believed that diabetes is the disease of intestines and pancreas get secondary affected. In diabetes surgery, re-routing of stomach and/or intestine is done which changes the gut hormones production. Enhanced production of these gut hormones like GLP-1 brings down the blood sugar levels.

Can all diabetes patients opt for this surgery?

Diabetic Surgery is generally recommended for people between 18-70 years age. A suitable candidate is one whose blood sugars are not well controlled (HbA1c of over 7 per cent) with medicines and has BMI of 27.5 or more.

There are two types of diabetes, Type 1 is the less common one (in ~10 per cent population). It usually happens in children and thus is also termed as Juvenile Diabetes. Because the problem is with the pancreas, the children need insulin right from the beginning. However, the common variety (in 80-90 per cent patients) is type 2 diabetes which is usually seen in adults. The primary problem is that the insulin produced by the pancreas is not effective/working, this is called insulin resistance. Thus, the muscle cells are not able to absorb the sugar from blood and hence blood sugars keep rising.

After diabetes surgery there is enhanced secretion of GLP-1 hormone from the intestine which reduces insulin resistance and thus body’s own insulin becomes effective, and most persons will not require insulin or even tablets for sugar control.

How is diabetes surgery better than other treatment options for diabetes?

Unlike tablet/insulin injections, which need to be taken daily for the whole life, diabetes surgery is a onetime intervention and diabetes can be reversed, depending on factors like duration of diabetes, pancreatic function, etc. which a diabetes surgeon will assess before offering surgery. It is established that the surgical response is better in those who get surgery done early as pancreatic function is still good. However even long-standing diabetics benefit from this surgery as well.

Is surgery a cure for diabetes?

Diabetes surgery does not cure diabetes, but it is as good as a cure. Diabetes surgery is not only about blood sugar control but more so about avoiding diabetes related complications like heart attacks, brain strokes, kidney failures, blindness or nerve damages. It is now known that this surgery reduces such complications by 33 per cent 65 per cent.

During the conversation, Dr Goel shared with us the results of a successful diabetes surgery that he had performed this year.

A diabetes patient, Mukesh Panchal (name changed) approached Dr Goel at Wockhardt Hospital for diabetes surgery in Feb 2022. The 52-year man was suffering from diabetes for over 25 years and was receiving three insulin injections daily for 12 years besides consuming many tablets. Still his after-food blood sugar was 258 before he approached Dr Goel.

Within a week’s time after undergoing diabetes surgery, all his diabetes medicines stopped, and he continues to have normal blood sugar levels even after 6 months, Dr Goel stated.

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