DIABETES AND BARIATRIC SURGERY

What types of diabetes are treatable

Diabetes mellitus is a chronic congenital disease (type 1 diabetes mellitus) and acquired (type 2 diabetes mellitus) which is directly related to obesity. and .. The first type is always insulin dependent, the second type is insulin independent, however, if poorly controlled, it can also be treated with insulin. Both types can be treated, but this is a lifelong diagnosis. Type 2 diabetes develops slowly, and with early diagnosis and proper treatment, there is a chance to put it into remission. However, more often the disease is detected at a late stage or the disease is poorly controlled, then the risks of complications increase. Complications include – chronic kidney failure, visual impairment and blindness, gangrene and amputation of limbs, reduced immunity, premature death.

What causes insulin dependence

Type 1 diabetes mellitus is characterized by an absolute deficiency of insulin due to the destruction of pancreatic B cells. This leads to a lack of the hormone insulin in the body, which causes hyperglycemia – an increase in blood glucose levels. Tissues dependent on insulin cannot get enough glucose, which leads to their breakdown. High glucose levels also lead to profuse urination and the appearance of glucose in the urine. Patients require lifelong insulin injections to achieve maximum compensation for metabolic disorders. Type 1 diabetes develops rapidly and is characterized by absolute insulin deficiency, unlike type 2 diabetes.

Treatment regimen

Treatment of diabetes mellitus is aimed at lowering glucose levels and improving the course of the disease. Treatment includes lifestyle changes, diet and exercise. For patients with type 1 diabetes, insulin therapy is indicated, and for type 2 diabetes, hypoglycemic drugs in combination with a diet. Patients should follow the recommendations of the diabetologist and select the load, taking into account the capabilities of the body and general health.

The effect of being overweight

Being overweight can cause many endocrine diseases, including type 2 diabetes, because white fat cells, which produce dangerous substances, grow in size when a person gains weight. One of the most dangerous hormones produced by adipose tissue is leptin, which causes weight gain. The more adipose tissue in the body, the more the sensitivity of cells to insulin decreases, which increases the likelihood of complications. Visceral fat, which accumulates around the abdominal organs, is especially dangerous. Treatment of diabetes without weight loss is usually ineffective, and people with severe obesity are at risk of developing many chronic diseases.

Bariatric treatments for obesity

The goal of bariatric surgery for diabetes is to reduce body weight to normalize glucose levels and improve metabolic processes, as well as to prevent diabetic complications. Normalization of glucose levels can occur already in the first weeks after surgery. So metabolism changes rapidly and insulin resistance decreases due to changes in appetite hormones. These surgeries are performed for type 2 diabetes, which is associated with obesity. It is recommended to perform operations in patients with diabetes with a BMI over 30, and especially if complications arise due to diabetes. Remission of diabetes up to 90% of people in the first year. It is important to keep in mind that the longer the history of diabetes in a patient, the less likely it is to go into remission. However, in any case, there is an improvement in the glycemic index and a decrease in drug doses. Gastric bypass is the gold standard treatment for type 2 diabetes associated with obesity. It reduces the size of the stomach and changes the path of the food bolus, reducing the absorption of nutrients. Sleeve gastrectomy may also be an effective treatment for obesity and diabetes. What operation can the surgeon help to choose.

X