What is Metabolic Surgery?
Metabolic surgery is a viable and low-cost treatment for obese Type 2 Diabetes patients with low risks. It also should be included in the treatment algorithm of other Type 2 Diabetic patients.
Diabetic Surgery
Gastrointestinal surgical procedures such as Bariatric Procedures, are very effective in treating Type 2 Diabetes.
During the first few days or weeks after Bariatric Surgery, a patient’s Type 2 Diabetes comes under control. This typically happens much earlier than the actual weight loss.
Studies indicate that such outcomes cannot be explained by the reduction of food intake and body weight.
Indications for Surgical Treatments of Type 2 Diabetes
A large number of cases show surgeries as an effective cure for Type 2 Diabetes and reduced diabetes-related mortality.
Randomised controlled trials have found that treatment of obesity and Type 2 Diabetes with bariatric–metabolic surgery is superior to medical therapy in controlling hyperglycaemia and cardiovascular risk factors over the medium term.
With this evidence, we consider broadening the surgical indications for some diabetes patients although they might not reach the BMI eligibility for bariatric surgeries.
When Should Metabolic Surgery be Considered?
Metabolic-Bariatric Surgery can be considered for:
Diabetics with High BMI
For severely obese patients (BMI>35) - Surgery must be a superb choice which causes weight loss and diabetes improvement.
Bariatric Surgery should become the early phase treatment option for severely obese patients instead of the last option.
Diabetics with Moderate BMI
For mild and moderately obese patients: BMI>30 or even BMI≥27.5 in Asian patients with Type 2 Diabetes, we recommend surgical treatment which is aligned with our eligibility standard.
The threshold of eligibility for Metabolic Surgery should be lowered and offered to patients who want to get a better control of their diabetes, especially those who are Asian or patients that have severe cardiovascular disease risks.
Diabetics with Normal BMI
For normal and overweight patients, initial data shows preferable outcomes with diabetes treatment. But this practice is still under review and awaiting additional outcome and safety evidence.
Who Can Benefit From Metabolic Surgery?
Metabolic surgery for Obese Type 2 Diabetic patients, who have failed to get cured by medication, especially for those with severe complications are well suited to this treatment. Metabolic surgery:
- helps a patient's blood glucose return to normal,
- reduces or avoids medication that can cause side effects
Further, Metabolic surgery is a potentially cost-efficient treatment.
Types of Metabolic Surgery
Our practice offers two types of Metabolic and Bariatric surgical procedures:
- gastric bypass, and
- sleeve gastrectomy.
They are the most common procedures performed in the world and provide the best balance between weight loss and safety.
Metabolic Surgery Risks
Diabetes can
- affect the healing of the surgical incision,
- increase the infection probability,
- raise the incidence of surgical complications and
- Increase perioperative risks.
Such risks can be even greater when the patient has metabolic syndromes such as:
- obesity,
- hyperlipidemia, and
- hypertension.
Surgeons prepare for these risks with a thorough surgery suitability evaluation.
Recovery from Metabolic Surgery
We perform surgery through small incisions (laparoscopically), which has been shown to reduce pain and enhance recovery.
By performing Metabolic and weight loss surgery through small keyhole incisions (laparoscopically) Patients recover more quickly, with minimal pain and have less risk for complications.
