TRADITIONAL THERAPY FOR DIABETES
The goal of treatment is to improve the symptoms of diabetes through normalizing blood
glucose levels. The ongoing goals are to prevent long-term complications like eye and kidney
disease, damage of nerves and blood vessels. Strict control of blood glucose reduces risk of death,
stroke, heart failure, and other complications. Glycosylated hemoglobin (HbA1C) is a test that
determines risk for long-term complications. It measures how much glucose has been sticking to
red blood cells and other cells.
The first-line treatment for type 2 diabetes is weight lost, diet and exercise. Appropriate
meal planning includes choosing healthy foods and eating the right amount of food. Exercise is
important for effective treatment of diabetes. Regular exercising helps burning excess calories,
managing weight thus improves control of the glucose amount in the blood.
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When diet and exercise are not sufficient to maintain normal blood glucose levels,
medications may be needed. They work through triggering the pancreas to make more insulin,
helping insulin work better, decreasing the absorption of carbohydrates from the gut or decreasing
glucose production in the liver. Poor blood glucose control despite lifestyle changes and taking
medications means insulin should be injected.
ROLE OF SURGERY
Despite continuing advances in diabetes pharmacotherapy, fewer than half of adults with type 2 diabetes mellitus (T2D) attain therapeutic goals designed to reduce long-term risks of complications, especially for glycemic control, and lifestyle interventions are disappointing in the long term.
Metabolic surgery, on the other hand, has been shown to improve glucose homeostasis more effectively than any known pharmaceutical or behavioral approach.
For the patients having diabetes for les than 5 years there is a high lifelihood of achieving normal blood sugar levels wihout any medications. If the person is obese and not yet requiring Insulin his chances of compelte stopage of medication and still acheiving normal sugar levels are very high. If they are having very poorly controlled diabetes , are on high dose of insulin and are having diabetes for a very long time, surgery helps in acheiving normal sugar levels with decresed requirements of Insulin and medications. Such patients may still need medications but they can achieve good glycemic control leading to prevention of diabetes related complications
While Metabolic surgery( Surgery for Diabetes) certainly has some risk, the long-term risk of continued diabetes (which is often inadequately treated with medication) typically outweighs the risk of a surgical procedure for most patients. Each patient’s individual risks for surgery, though, should be evaluated in the context of the duration and severity of their diabetes as well as their other obesity-related health problems.
THE EARLIER THE SURGERY, THE BETTER THE OUTCOME
A key finding of many studies is that the shorter the history of diabetes, the greater the
likelihood of complete remission. Glucose toxicity, particularly in poorly controlled diabetes,
accelerates B-cell failure. B-cells are located in the pancreas and produce and secrete insulin.
Weight loss can improve B-cell responsiveness to glucose. If the bariatric surgical procedure is
performed before irreversible B-cell failure has occurred, durable weight loss will be
accompanied by a high likelihood of long-term remission.
