Diabetes is now a very common disease in urban population of india.Incidence of diabetes in obese people is five times higher than normal weight people.
Diabetes is a disorder of carbohydrate metabolism. When Diabetes is associated with Obesity, then it is also called as Diabesity. As we all know since our school days teaching.
Diabetes is broadly classified into type 1 Diabetes mellitus and type 2 DM. In type 1 Diabetes mellitus, the problem is inadequate insulin secretion from Pancreas means absolute deficiency of insulin hormone. Patients of type 1 DM require insulin injections life long.
Type 2 DM is different from type 1 as in it there is resistance against insulin in the body which results in inability of insulin to perform its work i.e. Insulin is not able to push glucose into the cells which leads to increased concentration of glucose in blood and at the same time cells starving for glucose.
Type 2 DM is usually treated with medicines called OHAs(oral hypoglycemic agents).
Now question is how Bariatric surgery can cure Diabetes, let’s understand what we do in Bariatric surgery. Bariatric surgery involve variety of operations in which we make changes in your stomach and small intestine.
The operation specifically suitable for Diabetics is Gastric Bypass operation in which we create a small gastric(stomach) pouch out of the native stomach and connect it with small intestine(jejunum).
This new arrangement in body result in exclusion of Duodenum and proximal jejunum from food pathway(food doesn’t go in initial part of small intestine).
This leads to secretion of incretin hormones and decreased secretion of anti-incretin hormones.
Incretins are good hormones which work like insulin and help in control of blood sugar. So this sugar control after Bariatric surgery is weight loss independent, means just after bariatric surgery person becomes off diabetes medicines in most cases, though he achieves normal weight after 1 year of surgery.
One more mechanism also described for resolution of Diabetes is that after bariatric surgery(gastric bypass) food enters early into last part of small intestine(terminal ileum) which results in incretion hormones secretion and sugar control.
So summary of all the technical language above is that Bariatric surgery is an excellent method of weight loss in Obese people with Diabetes as their Diabetes get cured by this surgery along with attainment of normal weight and other health benefits of Bariatric surgery.