Metabolic Surgery

Some gastrointestinal surgical procedures, including standard performed bariatric procedures and several new unproven weight loss procedures turn to be effective in type 2 diabetes control, and even complete remission in many cases. During the first few days or weeks after the surgery, the patients' type 2 diabetes become under controlled, which happens much earlier than the actual weight loss. Studies indicate that such outcome can not be explained by reduction of food intake and body weight. 

Indications for Surgical Treatments of Type 2 Diabetes

• A large number of cases show surgeries could cure type 2 diabetes and reduced diabetes related mortality. From these evidences, we consider to broaden the surgical indications for some diabetes patients although they might not reach the BMI eligibility for bariatric surgeries.

  • (1) For severely obese patients (BMI > 35) : Surgery must be a superb choice which causes weight loss and diabetes improvement.

  • (2) For mild and moderate 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.

  • (3) For normal and overweight patients, with initial data show preferable outcome in diabetes treatment. But this practice is still investigational and awaiting additional outcome and safety evidences

Metabolic surgery is a viable and low cost treatment for obese type 2 diabetes patients with low risks. It should become the early phase treatment option for severely  obese patients instead of the last option. It also should be included in the treatment algorithm of type 2 diabetes. Because of the higher risks of diabetes and cardiovascular diseases in Asian patients, the threshold of eligibility of surgery should be lowered. 

Metabolic surgery may have the patient's blood glucose return to normal, reduce or avoid medication which is a potential cost efficient treatment.

Metabolic surgery is for type 2 diabetes patients with obesity and failed to get cured by medication, especially for those with severe complications.

 Metabolic Surgery should be the choice of type 2 diabetes patients with BMI ≥ 35.

 Metabolic Surgery should be the choice of patients with BMI between 30 - 35 who want to get a better control of the diabetes, especially those who have severe cardiovascular disease risks.

Diabetes can affect the healing of the surgical incision, increase the infection probability, raise the incidence of surgical complications and perioperative risks. Such risks can be even greater when the patient has metabolic syndromes such as obesity, hyperlipidemia and hypertension. We need fully prepared and give a fair evaluation whether the patient is suitable for a surgery or not. By performing Metabolic and weight loss surgery through keyhole small incisions (laparoscopically) you will recover more quickly, with minimal pain and have less risk for complications. 

Obesity is related to many illnesses such as: 

  • diabetes

  • heart disease

  • high cholesterol

  • sleep apnoea

  • arthritis

  • fatty liver disease

  • certain cancers

  • infertility


We offer 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. We perform surgery through small incisions (laparoscopically), which has been shown to reduce pain and enhance recovery.

Randomised controlled trials have found that treatment of obesity and T2DM with bariatric–metabolic surgery is superior to medical therapy in controlling hyperglycaemia and cardiovascular risk factors over the medium term.


Gastric Bypass

This operation involves surgical division of the stomach to create a gastric pouch, which is about the size of an egg. Next, the small intestine (Roux limb) is surgically connected to the gastric pouch. In doing this, food bypasses the stomach and first portion of the small intestine. The operation is 2-3 hours long typically and has an overall complication rate of 5-10%.

It is important to know that you may no longer take NSAID (non-steroidal anti-inflammatory) medications such as aspirin, ibuprofen, Motrin® or Advil®, since it can increase the chance of developing an ulcer between the gastric pouch and the small intestine. 

Gastric bypass surgery typically results 65-70% of excess body weight loss or approximately 45-70 kg.

Maximal weight loss occurs at 1 year and is only maintained if you adhere to the appropriate diet and exercise regimen.

On average, patients that undergo laparoscopic surgery are hospitalized for 2-3 days and can return to work 2-4 weeks after surgery.

Before surgery, every patient is placed on a specific preoperative diet clinically proven to reduce the size of the liver and make surgery safer. 


Sleeve Gastrectomy

This operation involves surgical division and removal of approximately 80-85% of the stomach. The operation is 1-2 hours long typically and has an overall complication rate of 2-5%.

Sleeve gastrectomy surgery typically results 55-65% of excess body weight loss or approximately 30-45 kg.

Maximal weight loss occurs at 1 year and is only maintained if you adhere to the appropriate diet and exercise regimen.

On average, patients that undergo laparoscopic surgery are hospitalized for 2-3 days and can return to work 2-4 weeks after surgery.

Before surgery, every patient is placed on a specific preoperative diet clinically proven to reduce the size of the liver and make surgery safer.