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How can bariatric surgery treat diabetes?

September 17, 2019

Bariatric surgery is indicated in patients
who have a BMI of more than 35. The reason for that is once you cross a certain level
of BMI, then patients are at a higher risk of developing serious medical conditions such
as diabetes, high blood pressure, and sleep apnoea. These medicial conditions can give
rise to more serious conditions such as heart disease, stroke, and cancer. Now, there is
a lot of evidence that bariatric surgery not only prevents the occurence of these serious
medical conditions, but there’s also a lot of evidence that bariatric surgery reverses
these serious conditions and can actually help patients live longer, and thus it prolongs
the survival of these patients when they have undergone surgery. There are four common procedures: in terms
of surgery that’s done by laparascopic surgery, there’s the gastric banding, the gastric sleeve
with a sleeve gastrectomy, and the gastric bypass. In terms of endoscopic procedures
there’s the gastric balloon, and these are the four most common procedures to help patients
lose weight. They all have a role to play, they’re all effective in different ways for
different patients, but the two most common procedures that I perform are the gastric
sleeve, or the sleeve gastrectomy, and the gastric bypass. Both these procedures are
very effective: they help patients not only lose weight but also in the sustaining of
their weight loss. Of these two procedures, if I had to pick one which I think is most
fascinating and most interesting, I would pick the sleeve gastrectomy, because in my
experience in terms of weight loss, it is nearly as effective as a gastric bypass. More
importantly, it comes without the long-term side effects of a gastric bypass. That’s the easy part of the decision-making
process, because they (the patient) have decided that they do want to consider surgery to lose
weight. The next challenge for them is to then choose the procedure that they think
will work best for them, and I think it’s very important to help patients make that
choice, but that choice has to be theirs because they’re the ones who are going to live with
this operation for the rest of their life. Now, all these procedures work really well
in some patients, but may not work so well in other patients, and the procedures are
also chosen based on other factors, for example patients’ eating behaviours. Some patients
may eat very bulky meals, and so for them a procedure like a sleeve gastrectomy would
be ideal. Some patients may already have diabetes mellitus, and for them the gastric bypass
would probably be the procedure of choice. So the decision-making process very much is
a partnership between the patient and me, but I would like patients to make this choice,
and I can only facilitate this process by giving them the right information. Bariatric surgery is highly successful, and
that’s the reason why there are so many procedures that are being performed safely and effectively
across the whole world. Bariatric surgery’s key success measures are weight loss, and
a sleeve gastrectomy and a gastric bypass are associated with nearly 25-30% of total
body weight loss, usually at one year, two, or two and a half years, and these are sustained
even up to ten or fifteen years after surgery. Another success measure of bariatric surgery
is resolution of diabetes, which is that diabetes can actually be treated via surgery, and that’s
a fascinating concept because earlier I think physicians were only controlling diabetes.
Up to 50-70% of patients can have complete resolution of diabetes.

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  • Reply AbdelAzeez Sobh February 26, 2019 at 9:19 am

    Weight loss surgery to treat diabetes

    Read More:

  • Reply Jay M April 27, 2019 at 5:16 pm

    Don't do it.

  • Reply Eman Arif June 2, 2019 at 8:58 pm

    what do u reccomend fot type 1 diabetics? is mini gastric bypass a good choice?

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