The association of type 2 diabetes with OVERWEIGHT- OBESITY is so consistent that has led to define the concept of DIABESITY.
Obesity increases the resistance to the action of pancreatic insulin causing Type 2 diabetes. Actually, we can point the surgical technique to treat that COMORBIDITY, while achieving weight reduction. This is called METABOLIC SURGERY or SURGERY OF THE DIABETES. In addition it is also effective against hypertension, dyslipidemia, hyperuricemia, OSAS, etc.
DIABETES causes elevated levels of blood sugar, which attacks organs such as the retina of the eye (causing blindness), the nervous system (diabetic neuropathy, sexual impotence), kidney (renal failure and dialysis), blood vessels (foot ulcers and amputations, heart attacks), etc.
Currently, we know that some surgical techniques are capable to improve and even cure Type 2 Diabetes, recovering health and avoiding take medications and pricking insulin.
The metabolic effect of these techniques on diabetes is based on the modification of gastrointestinal transit and hormones – Incretines (GLP-1, CCK, YYpeptide, Ghrelin…), facilitating the action of pancreatic insulin. All these effects determine the remission of diabetes which occurs IMMEDIATELY after surgery.
Patients are discharged from the hospital without taking any diabetes treatment in most cases, and never INSULIN again.
The other co-morbidities such as hypertension, dyslipidemia, sleep apnea, etc. It takes a few months to improve or even disappear, and may require a period with progressive reduction treatment. This is because those comorbidities resolution are more weight loss dependant.
Both Laparoscopic SLEEVE GASTRECTOMY and LAPAROSCOPIC GASTRIC BYPASS are effective against diabetes, which disappears in 80-90% of patients and improves in the remaining 20%. However, GASTRIC BYPASS seems more effective against hypertension and dyslipidemia. Both techniques also facilitate weight loss.
Metabolic surgery of the DIABETES is particularly indicated in patients with overweight-obesity (BMI> 30) and TYPE 2 DIABETES (resistance to insulin action). The best results are obtained in patients with less than 10 years of diabetes history, with good pancreatic reserve (C-peptide), and not yet under insulin. Nevertheless, insulin-dependent diabetics also respond well and leave pricking insulin.
In Type 1 diabetics, which has an autoimmune origin in which the pancreas is self-destroyed, this surgery can help improve glycemic control (blood sugar) and reduce insulin requirements, but is not the treatment of choice for the disease.
Metabolic surgery is effective against type 2 diabetes, improves quality of life and is estimated to extend the life expectancy of these patients in 10 years.
