Diabetes surgery encompasses various operations under a general term. Individuals who cannot control their diabetes can achieve better management or resolution of the condition through obesity and metabolic surgeries. To avoid confusion caused by technical terms, these procedures are collectively referred to as diabetes surgery. Among the most common types of diabetes surgeries are gastric sleeve surgery and gastric bypass surgery. Additionally, transit bipartition and ileal interposition surgeries fall under the scope of diabetes surgeries. The choice of surgery is determined based on the patient’s type of diabetes and weight status.
History of Obesity Surgeries
With a history spanning over 30 years, obesity surgery has proven its success through the data collected. Initially used primarily for weight loss, obesity surgeries have evolved with new approaches. The first gastric sleeve surgery was performed in the United States in 1988. Today, it is among the most frequently performed surgeries in Turkey and holds significant importance worldwide.
Gastric sleeve surgery and gastric bypass surgery are the most preferred diabetes surgeries. In recent years, transit bipartition has emerged as a new option within diabetes surgeries. However, because it is relatively new and lacks sufficient long-term data, it is not an approved procedure in the United States.
Another innovative approach, ileal interposition surgery, is performed on non-obese patients with Type 2 diabetes. This complex procedure must be conducted by highly skilled surgical teams. Clinical data shows promising success rates, although the surgery is not yet approved in the United States, where conducting unapproved procedures is prohibited.
Standard Practices in Diabetes Surgeries
Standardization is critical to ensure the success of procedures and maximize patient outcomes. Globally recognized surgeries such as sleeve gastrectomy, gastric bypass, duodenal switch, and biliopancreatic diversion have undergone rigorous standardization processes. These surgeries are approved and widely performed after meeting strict criteria.
Currently, unapproved surgeries like transit bipartition and ileal interposition await long-term results to gain approval. Following the evaluation of these results, successful procedures are standardized and eventually approved for widespread use.
The success of gastric sleeve surgery in treating diabetes has been well-documented, making it a safe and effective procedure for many years. Patients are advised to prioritize approved and proven techniques for safety. Attempting unapproved surgeries carries significant risks.
Types of Diabetes Surgeries
There are a total of 10 different types of diabetes surgeries, all involving the stomach and small intestine. The choice of surgery is determined by the patient’s specific needs and suitability. Procedures such as ileal interposition, duodenal switch, SADI-S, gastric bypass, and transit bipartition are tailored to address individual requirements effectively.
Why Are the Small Intestines Targeted in Type 2 Diabetes Surgeries?
Metabolic surgeries aim to regulate hormones. The small intestine contains hormones that either increase insulin sensitivity or resistance. Hormones that increase resistance are located at the beginning of the intestine, while those that enhance sensitivity are found at the end. Processed and simple foods are digested before reaching the intestine’s final segment, preventing the release of beneficial hormones that boost insulin sensitivity.
To resolve this issue, portions of the intestine may be rearranged. Moving the final segment of the intestine to the beginning enables nutrients to stimulate the release of hormones that improve insulin sensitivity. This change allows the body to utilize insulin already produced but previously unused.
Who Is Eligible for Diabetes Surgery?
Diabetes surgery is suitable only for Type 2 diabetes patients. In Type 1 diabetes, the primary issue is the lack of sufficient insulin reserves in the pancreas. Consequently, Type 1 diabetes patients must rely on insulin to manage their condition.
For overweight diabetes patients, obesity surgeries like gastric sleeve and gastric bypass are the most commonly chosen options. For non-obese Type 2 diabetes patients, procedures like transit bipartition and ileal interposition may be considered.
Determining Eligibility for the Surgery
A detailed evaluation is essential to determine the appropriate procedure and assess a patient’s eligibility for surgery. Only with accurate data can the correct surgical option be chosen. Following the surgery, patients must adhere to specific dietary and exercise plans. Diabetes surgeries alone do not guarantee success; patients must actively participate in their own recovery and lifestyle changes.
The pre-operative, operative, and post-operative phases should be viewed as an integrated process. To achieve successful outcomes and meet targeted goals, close monitoring and attention to critical aspects throughout the process are essential.
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