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Diabetes Treatment

Diabetes is a group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced.

There are largely 2 types:

  • Type 1 results from the body’s failure to produce insulin, while
  • Type 2 results from insulin resistance, a condition in which cells fail to use insulin properly.

Complications due to Diabetes

  • Macro-vascular complications occur due to accumulation of fat within the walls of the blood vessels (atherosclerosis).
  • Coronary artery disease (Ischemic heart disease),
  • Peripheral vascular disease (reduced or loss of blood supply to the legs resulting in non-healing ulcers, gangrene of toes or limbs),
  • Stroke (reduced blood supply to the brain causing damage),
  • Erectile dysfunction.
  • Diabetic retinopathy (damage to the retina in eye and blindness),
  • Diabetic nephropathy (damage to the kidney, renal failure) are some examples


Causes of Diabetes

Causes of diabetes depend upon the type of diabetes a person have. Some factors that increase the risk for diabetes are age and ethnicity.

Type 1 diabetes causes       

Type 1 is an autoimmune condition, a condition in when the immune system, which normally keeps the body safe against disease, attacks itself instead, that destroys the cells in the pancreas that make insulin, called beta cells. People, who have certain genes passed on from parents, are more likely to develop type 1 diabetes and being exposed to a trigger in the environment, such as virus is also thought to play a part in developing diabetes.

Type 2 diabetes causes

Pancreas makes a hormone called insulin. Insulin helps your cells turn glucose from the food you eat into energy. Insulin transport glucose from your blood stream to cells throughout your body. Insulin resistance is a condition where insulin is still produces but unable to use it properly, this condition is often seen in obese or overweight people or people living unhealthy lifestyle. People who are obese or overweight, less physical activity, unhealthy diet, smoking, high blood pressure, a history of gestational diabetes, and high fasting blood glucose levels are at higher risks. Family history, individuals with a parents and siblings with the type 2 diabetes have higher risk of developing type 2 diabetes. As age increases the risk of developing the type 2 diabetes increases.


Symptoms of Diabetes

There are diabetes warning signs and symptoms that both women and men have in common, for example:

  • Always feeling hungry
  • Frequent urination
  • Weight loss or gain
  • Fatigue and Nausea
  • Blurred vision
  • Slow-healing wounds
  • Skin infections
  • Darkening of skin in areas of body creases
  • Breath odour that is fruity, sweet, or an acetone odour
  • Tingling or numbness in the hands or feet


The Cure for diabetes

Now the Surgeons have found out a cure for diabetes. It has been found that certain hormones which are responsible for Blood Sugar levels can be manipulated with the help of surgery. Thus, if we do a metabolic surgery of stomach and rearrange small bowel, this leads to changes in several gut hormones that control the release of insulin and its action. It cures as a result of several factors, some of them are increased incretins, reduced anti-incretins, reduced ghrelin, increased action of leptin, rapid emptying of the stomach, calorie restriction and weight loss.

Sleeve Gastrectomy is a metabolic surgery that results in calorie restriction and weight loss. Weight loss has a positive impact on maintaining normal glucose levels in the blood. Weight loss increases insulin action, reduces damage to beta cells in the pancreas. If surgery is performed on normal weight diabetic patients, weight loss is not much or will not be there. Thus these patients become free of diabetes.

Diagrammatic Explanation of laparoscopic sleeve gastrectomy with duodenoileal interposition to treat diabetes

It is the most effective metabolic surgery. In this type of surgery, up to 80 percent of the left side of the stomach is removed and the first part of the duodenum is disconnected using linear cutter stapler. A significant segment of the ileum is isolated by dividing the ileum proximal to the Junction of the small and large bowels. Bowel continuity is restored by joining the remaining ends of the ileum and all the mesenteric gaps are closed. In this operation Ghrelin hormone – the hormone responsible for hunger production is reduced, as the fundus of the stomach is removed.

Laparoscopic sleeve gastrectomy with duodenojejunal bypasses (sg – djb):

It is actually a combination of Sleeve Gastrectomy with a roux – en – y gastric bypass. In this type of surgery, up to 80 percent of the left side of the stomach is removed and the first part of the duodenum is disconnected using linear cutter stapler. The jejunum is divided distal to duodenojejunal flexure and Bowel continuity is restored and all the mesenteric gaps are closed. To become eligible for this patient. The person needs to be suffering from type 2 diabetes that is fit, aged between 18 to 65 years, duration of diabetes should be > 3 years and < 20 years.


The Results

As a result of this surgery in obese people, because of the narrow stomach tube, food intake is restricted, which leads to calorie restriction and weight loss. All these factors contribute to the resolution of diabetes in more than95 percent of type 2 diabetic patients.

In more than 65% of patients, HbA1C becomes < 6% and in 30% of patients, HbA1C level between6 and 7 % is achieved. Patients are off insulin and tablets. More importantly, it is almost a certainty that you are Diabetes Free!!!