How does a Metabolic Surgeon perform a Metabolic surgery?
The surgical procedure involves bringing the distal (end part) part of the small intestine (ileum) nearer to the proximal (first part) part somewhere nearer to the stomach using advanced laparoscopic methods. It is basically a type of malabsorption procedure.
How does Metabolic Surgery bring Diabetes under control?
The reason why metabolic surgery reduces diabetes is still research. One of the popular proposes that the blood sugar level becomes near normal resulting in remission from diabetes.
This theory proposes that directly passing off the food to the proximal part of the small intestine (ileum) stimulates a peptide called GLP-1 or incretin. This peptide delays gastric emptying, promotes satiety (feeling of fullness), suppresses further appetite, inhibits glucagon secretion (a hormone that increases sugar level), decreases gluconeogenesis (converting fat and protein into sugar) and stimulates glycogenesis (converting sugar into glycogen). The elevation of incretin also improves insulin sensitivity.
Metabolic surgery also results in a decrease in a peptide called Ghrelin. This reduction in this peptide decreases the secretion of glucagon, cortisol, and growth hormones. These three hormones together are the antagonist of insulin. The decrease in Ghrelin also results in increased insulin secretion.
In simple terms, the Ileal Interposition Surgery or Metabolic Surgery increases insulin sensitivity and decreases insulin resistance. This results in remission of diabetes. It is borne in mind that metabolic surgery for diabetes is only for people that have no obesity conditions, but have severe co-morbid conditions like type-2 diabetes, etc. This surgery type may result in mild weight loss also though it is not intended for weight loss.
Reduction of other co-morbid conditions after undergoing the Surgery
Yes, metabolic surgery drastically reduces most of the other co-morbid conditions also along with uncontrolled blood glucose. Amazingly the blood sugar level is brought to near normal within a few days after the metabolic surgery. Here is an interesting statistics.
(1) Drastic reduction of severity of diabetes in 85% of individuals who underwent this surgery for diabetes.
(2) Over 70% reduction of cholesterol level post-surgery.
(3) Hypertension or high blood pressure decreased by over 80%.
(4) 90% of the patients experienced near cure of sleep apnea.
(5) Improvement in joint pains.
(6) Ease of respiration.
How about Weight Loss in Metabolic Surgery for diabetes?
This surgery is only for people who are not obese but have uncontrolled diabetes and other co-morbid conditions like
- Hypertension
- High triglycerides
- Hyperlipidemia
- Sleep apnea, etc
.
In a nutshell, Dr Maran, the metabolic surgeon in Chennai who has done many metabolic surgery in Chennai, India says that people who are morbidly obese with co-morbid conditions are recommended for Bariatric Surgical Procedures and people who are of normal weight but with severe co-morbid conditions are recommended for Metabolic Surgeries. That is why this surgery is known as metabolic surgery for diabetes or simply surgery for diabetes.
