What is Diabetes Surgery

What is Diabetes Surgery?

Diabetes Surgery is term that is used to define a group of surgical interventions to treat Type 2 Diabetes mellitus. Diabetes Surgery is called as "Metabolic Surgery" in some sources. There for Diabetes Surgery and Metabolic Surgery terms define the same thing. The reason for this is a special medical condition called "metabolic syndrome. In metabolic Syndrome the patient suffers from obesity, diabetes, hypertension and dyslipidemia at same time. When Diabetes Surgery Operation (Metabolic Surgery) is applied, obesity and type 2 diabetes are treated as well as the other components of methabolic syndrome which are hypertension, dyslipidemia, Sleep Apnea and Polycystic Ovary Syndrome.

What are the Diabetes Surgery Operations

After a detailed properative evaluation and careful patient selection some operation may be used to treat obesity and type 2 diabetes, thus there are more than one diabetes oprations. Di,abetes operations generally are; Gatsric Bypass, Transit Bipartition, SADI-S, Duodenal Switch, Billiopancreatic Diversion, Ileal Interposition. Even Gastric Sleeve operation can treat Type 2 Diabetes in some patient. Gastric Sleeve surgery treats type 2 Diabetes in 60% of the diabetic patients who also suffer from central obesity. The success rate of Diabetes Surgery operations me ntion above differs from 80-92% in treating type 2 Diabetes and quitting insulin injections.

How does a Diabetes Surgery Operation work?

Diabetes Surgery works in combination of different pathways. Generally they reduce body weight and this in turn treats the peripheric insulin resistance which means body utilizes insulin more easily. Because allmost all kinds of Diabetes Surgeries (Except Ileal Interposıtıon) are "bypasses" in nature the calorie intake drops , this is also another pathway in controlling diabetes. In al of the types of Diabetes Surgery Operations, food enters the small intestine from its far part (distal intestine), this causes an increase in a very special hormone called "GLP-1). GLP-1 has very strong effects on pancrease and brain. GLP-1 effects can be summarised as following:

- Induces food satiety in brain.

- Increases muscle metabolism.

- Slowdowns the absorption from intestine

- Decreases Hunger hormone level

- Stops pancreatic B-cell destruction

- Increases B-cell number in Pnacreas

- Insulin secretion increases significantly after the increase in blood GLP-1 hormone level.

What is Transit Bipartion Operation

Transit Bipartition Operation is the oepration of choice of our clinic, and we have special reasons for this. Transit Bipartition is a special type of Bypass still having many advantages over classic Gastric Bypass.

- Transit Bipartition takes only 120 minutes to perform just as Gastric Bypass

- In Transit Bipartition you can treat esophageal reflux also just like gastric bypass, you can perform Transit Bipartition in Omega loop or in Roux-en-Y style according to the special needs of the patient.

- The excluded stomach portion is removed out of the body contrary Gastric Bypass where this stomach portion is left in the body as a closed box.

- After Transit Bipartition advanced billiary interventions like ERCP easily can be applied if required, this is a challenge in Gastric Bypass.

- It is ver easy to make a Revision / Conversion surgery or to perform after Transit Bipartion contrary to Gastric Bypass.

- Vitamin malsbsorption is far less than Gastric Bypass in Transit Bipartition.

What is the preoprative preperation procedure of Transit Bipartition Operation?

Preoperative preparation procedure is just as same as gastric sleeve surgery in Transit Bipartition operation. A wide blood test panel including all hormone tests like c-peptide, cortisol, thyroid hormones, vitamins...etc, all neccessary consultations like cardiology, chest medicine, internal medicine, endocrinology and anesthesia, imaging test like abdominal ultrasound/MRI, a detailed endoscopical examination are performed in the preopertative evaluation period.

METABOLIC SURGERY - FREQUENTLY ASKED QUESTIONS

FAQs About Metabolic Surgery for Type 2 Diabetes in Malta

What is Metabolic Surgery?

Metabolic surgery refers to surgical procedures designed specifically to treat metabolic diseases like type 2 diabetes. These surgeries not only promote significant weight loss but also improve metabolic functions by altering gut hormones and the microbiome.

How Does Metabolic Surgery Help in Managing Type 2 Diabetes?

Metabolic surgery helps manage type 2 diabetes through several mechanisms:

Weight Loss: Reduces insulin resistance significantly.
Hormonal Changes: Increases beneficial hormones like GLP-1, improving insulin sensitivity.
Gut Mechanisms: Alters the digestive tract, enhancing nutrient absorption and gut microbiota, leading to better blood sugar regulation.

What Types of Metabolic Surgery are Available?

Several types of metabolic surgeries are effective in managing type 2 diabetes:

Gastric Bypass: Reroutes the digestive system, bypassing most of the stomach and part of the small intestine. This procedure has a high rate of diabetes remission.
Sleeve Gastrectomy: Involves removing a large portion of the stomach to limit food intake and favorably impact gut hormones.
Adjustable Gastric Band: Places a band around the upper part of the stomach to create a small pouch, limiting food intake.
Duodenal Switch (DS), Biliopancreatic Diversion (BPD), and Single Anastomosis Duodeno-Ileostomy with Sleeve (SADI-S): These are specialized procedures designed to enhance metabolic benefits and diabetes management.

How Effective is Metabolic Surgery in Treating Type 2 Diabetes?

Studies have shown that up to 78% of patients experience remission of type 2 diabetes post-surgery. This means they can reduce or eliminate their need for diabetes medications and enjoy better glycemic control.

What Are the Long-term Benefits of Metabolic Surgery?

Long-term benefits of metabolic surgery include:

Improved blood sugar control
Reduced need for diabetes medications
Lower risk of diabetes-related complications such as heart disease, stroke, and kidney failure
Significant and sustained weight loss

What Are the Risks and Considerations of Metabolic Surgery?

While metabolic surgery offers significant benefits, it requires a commitment to long-term lifestyle changes, including diet and exercise. Regular follow-ups with healthcare providers are essential to monitor and manage any potential complications.

Why Have Type 2 Diabetes Rates Increased Over the Past 50-60 Years?

The surge in type 2 diabetes rates can be attributed to several factors:

Dietary Changes: Increased consumption of refined foods and simple carbohydrates.
Obesity: A strong link exists between obesity and type 2 diabetes.
Sedentary Lifestyle: Decreased physical activity due to technological advancements.
Aging Population: Higher prevalence of age-related diseases as people live longer.

How Does Malta Benefit from Offering Metabolic Surgery In Malta?

By providing advanced treatments like metabolic surgery, Malta enhances comprehensive care for type 2 diabetes, offering hope and improved quality of life for many individuals struggling with this condition and obesity.

Who Should Consider Metabolic Surgery In Malta

Individuals with type 2 diabetes and a body mass index (BMI) of 30 or higher, especially those who have struggled with other weight loss methods, should consider metabolic surgery. Consulting with healthcare professionals to understand the risks and benefits is crucial.

For more detailed information and personal consultation, it's advisable to speak with healthcare providers specializing in metabolic and bariatric surgery in Malta.

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