How is Diabetes Surgery Performed?

Obesity, which is one of the most common diseases of our age, can cause individuals to face different diseases. One of these diseases is type-2 diabetes. Due to type-2 diabetes, which is a health problem that occurs due to excess weight, patients may need to take insulin regularly and continuously. In addition, there is a risk of encountering different diseases in the later stages of the disease.

Since obesity and diabetes are seen in more and more patients every day, various treatment methods are used and these methods are being developed day by day. With medical treatment, type-2 diabetes cannot be completely cured, and it is only aimed to keep the patient’s blood sugar under control. With the application of metabolic surgery procedures in appropriate patients, the treatment of type-2 diabetes is largely possible.

Thanks to the extremely successful results depending on the surgical procedure applied, various health problems of the patients can be corrected with metabolic surgery, and the need for medical treatments for insulin control is largely eliminated.

What is Diabetes Surgery?

Metabolic surgery, also called diabetes surgery, can be defined as surgeries performed for the simultaneous control of diabetes and obesity. Diabetes mellitus is divided into type 1 and type 2. Type-2 diabetes, where there is insulin production in the body but such insulin is insufficient, is often associated with obesity.

Type-2 diabetes patients have insulin resistance. Healthy individuals feel their hunger and eat with the hormone secreted from their stomachs. With the eaten food, the stomach wall is stretched and the secretion of the hunger hormone stops with the stimulus to the brain, and the person begins to feel full. Digestion and absorption begin when food passes into the intestines. In healthy individuals, undigested food reaches the last parts of the small intestine very easily.

Undigested foods cause the glp-1 hormone to be secreted from here. This hormone helps to control blood sugar by providing more active insulin secretion from the pancreas.

Obese people, on the other hand, have larger stomachs and more hunger hormone secretions. For this reason, obese people use larger portions to feel full or feel the need to eat more often. On the other hand, obese people have more intestinal length and a higher number of villi that provide food absorption. As a result, undigested food cannot reach the last part of the intestine, and the glp-1 hormone cannot be activated. Since the insulin in the pancreas cannot be released actively, blood sugar rises. Diabetes starts as blood sugar rises excessively with the effect of insulin resistance.

Curiosities About Diabetes Surgery

Diabetes surgery, that is, metabolic surgery procedures are applied with the closed method. Generally, 4 to 6 small incisions are made and procedures deemed appropriate for the patient are applied with various methods. The common feature of metabolic surgery operations is to reduce appetite and limit food intake with interventions to the stomach, and to make shortcuts that will allow food to reach the last part of the small intestine.

A large part of the stomach is removed within the scope of gastric sleeve surgery, which is one of the treatment methods for type-2 diabetes and obesity. Connection points are left to the esophagus and intestines, which will ensure the continuity of the digestive system of the stomach. It has effects such as reducing the stomach volume of the patient, ensuring that they are full by eating much less food, and reducing the appetite since the area where the hunger hormone is secreted is removed. 

In transit bipartition surgery, which is applied in addition to gastric sleeve surgery, connection points are created between the small intestine and stomach after gastric sleeve surgery. Most of the food consumed passes through the new port and is absorbed in the small intestine.

Gastric bypass surgery, which is one of the most common and effective methods for the treatment of type-2 diabetes, changes the stomach and small intestine. A pouch is created in the stomach and connected with the lower part of the intestine. The part of the small intestine that was separated in the first stage is reattached to the lower part. The purpose of the changes is to shrink the stomach, reduce food consumption, and minimize food absorption in the small intestine. Thus, the consumed foods do not pass through the stomach and small intestine. When the patient loses weight rapidly, improvement in type-2 diabetes is also achieved.

In ileal interposition, which is one of the metabolic surgery methods, it is aimed to replace the beginning and end parts of the small intestine and to increase the hormone level. As a result, insulin resistance hormones in the duodenum, stomach, and pancreas decrease. At the same time, an increase in insulin sensitivity hormones occurs in the small intestine. Ileal interposition is usually performed together with sleeve gastrectomy surgery. Since it is a procedure that changes hormone balances, it is considered one of the preferred effective methods in the treatment of type-2 diabetes.

Although effective results are obtained in most diabetic patients after metabolic surgery procedures, it is possible to increase the success rate if the patients make changes in their lifestyle and eating habits. The decision to implement diabetes surgery should be made after the evaluations made for each patient.