Diabetes is a condition in which blood sugar (glucose) levels in the body remain above the normal range. It arises when the hormone insulin is not produced in sufficient quantities or is not used effectively. Diabetes must be diagnosed and treated by a medical specialist.
- Type 1 Diabetes: The immune system attacks the insulin-producing cells of the pancreas, preventing the body from making insulin. This type of diabetes often appears in childhood or adolescence and requires insulin therapy.
- Type 2 Diabetes: While the body still produces insulin, the cells become resistant to it. This form typically appears in adulthood, requiring lifestyle modifications, dietary adjustments, and sometimes medication.
What Is Diabetes?
Managing diabetes involves monitoring blood sugar levels, adopting a healthy diet, engaging in regular exercise, and using medications when necessary. Any questions about diabetes treatment or management should be discussed with a healthcare professional. Diabetes is also known as sugar disease. The fundamental problem is that the body struggles to regulate blood sugar effectively, either because of insufficient insulin production or insulin resistance.
- Type 1 Diabetes occurs due to an autoimmune process targeting pancreatic cells producing insulin.
- Type 2 Diabetes occurs when the body still makes insulin but cannot use it effectively. It is closely associated with factors such as genetics, obesity, and lifestyle.
If not effectively treated, diabetes can damage many organ systems and lead to health complications like heart disease, kidney failure, eye problems, and nerve damage (neuropathy).
Type 1 Diabetes
Proper control of diabetes often requires consistent monitoring of blood glucose, following a balanced diet, regular exercise, and, in many cases, pharmacological interventions. Type 1 diabetes is an autoimmune condition in which the body’s immune system destroys the insulin-producing cells in the pancreas. Because the body cannot produce insulin on its own, external insulin injections become a lifelong requirement. Type 1 diabetes typically appears in childhood or adolescence and persists throughout one’s life.
Type 2 Diabetes
In Type 2 diabetes, the body’s cells develop resistance to insulin, or the pancreas cannot produce enough insulin to compensate. This condition often arises with increased age, but is also linked to excess weight, genetic predisposition, and lifestyle habits. Over time, chronically elevated blood glucose can lead to organ damage if not managed properly.
What Causes Diabetes?
Diabetes develops from multiple factors, particularly when the body cannot properly regulate glucose:
- Genetics / Family History: A strong familial tendency can increase the likelihood of developing diabetes.
- Excess Weight / Obesity: Particularly increased abdominal fat can elevate the risk of type 2 diabetes by impairing insulin activity.
- Lifestyle and Environmental Factors: A sedentary lifestyle and a diet high in simple sugars and fats are key contributors to insulin resistance and type 2 diabetes.
Signs & Symptoms of Diabetes
While symptoms can vary between types 1 and 2, the following are common:
- Excessive Thirst (polydipsia)
- Frequent Urination (polyuria)
- Persistent Fatigue
- Blurred Vision
- Unexplained Weight Changes (loss in type 1; often gain in type 2)
If these symptoms occur, medical testing (blood glucose tests, HbA1c, etc.) is warranted. Early detection and proper treatment can help prevent complications.
How Is Diabetes Treated?
Diabetes management aims to keep blood sugar within healthy ranges. Treatment approaches differ depending on the type of diabetes and individual needs:
- Type 1 Diabetes
- Requires insulin therapy (e.g., injections or pump) because the body produces little to no insulin.
- Lifestyle changes, diet, and exercise are crucial alongside insulin.
- Type 2 Diabetes
- Emphasizes lifestyle interventions: balanced eating, calorie control, regular physical exercise, and weight management.
- Oral medications (e.g., metformin) or, in some cases, insulin may be used.
- In certain instances, metabolic or bariatric surgery can be considered, especially when other treatments fail to achieve sufficient glucose control.
Effective treatment depends on regular check-ups, blood glucose monitoring, and adopting lifelong healthy habits.
Preventing Diabetes
A healthy lifestyle is essential to reducing the risk of type 2 diabetes, including:
- Maintaining a Healthy Body Weight
- Regular Exercise (≥150 minutes/week of moderate aerobic activity)
- Balanced Diet low in sugar and refined carbs
- Managing Stress
- Adequate Sleep
Diabetes Surgery
Diabetes surgery or “sugar surgery,” commonly referred to as metabolic surgery, is especially beneficial for type 2 diabetes. It can also help hypertension, metabolic syndrome, obesity, dyslipidemia, and related health issues. These conditions greatly affect quality of life, but metabolic (or “diabetes”) surgery can often bring them under control. Many patients see significant improvements, especially if they are diagnosed early.
What Is Diabetes Surgery?
“Diabetes surgery” encompasses various metabolic operations used to control or potentially cure type 2 diabetes. Physicians select the most appropriate procedure based on a patient’s obesity status, comorbidities, and lab findings. Key to most such surgeries is either:
- Reducing the stomach’s capacity so that the patient eats less but feels full earlier, and/or
- Reducing nutrient absorption by bypassing part of the small intestine.
For instance, some obesity operations such as Gastric Bypass, Mini Gastric Bypass, Duodenal Switch, Transit Bipartition, Ileal Interposition, and Sleeve Gastrectomy have shown efficacy in type 2 diabetes remission.
Who Can Have Diabetes Surgery?
Not all diabetes patients qualify. Type 1 diabetes patients are generally not suitable because their pancreas cannot make insulin at all. Surgery won’t replace insulin production. Type 2 diabetes patients are prime candidates, especially if:
- They’re obese (BMI ≥ 30-35) and cannot achieve glucose control despite medication.
- They have residual insulin secretion capacity in the pancreas.
- They’ve struggled with type 2 diabetes and obesity for fewer than ~10 years (giving them the best chance of insulin independence).
In addition, thorough testing (insulin levels, C-peptide, medical history) helps determine candidacy.
How Is Metabolic (Diabetes) Surgery Performed?
Metabolic surgery procedures are typically done laparoscopically (via small incisions). Examples include:
- Gastric Bypass: A small stomach pouch is created, and part of the small intestine is bypassed.
- Sleeve Gastrectomy: ~80% of the stomach is resected to create a slender “sleeve.”
- Mini Gastric Bypass: Similar to gastric bypass but simpler and shorter in operative time.
Post-op hospital stays average 3–4 days if everything is stable. Full results unfold over ~18-24 months, requiring strict diet, exercise, and supplementation.
Risks of Diabetes (Metabolic) Surgery
All surgeries carry risks, such as:
- Infection
- Bleeding
- Leakage at staple lines
- Nutritional/vitamin deficiencies (lifelong supplements may be necessary)
- Blood clots
- Dumping Syndrome (if certain high-sugar foods are consumed post-op)
Nevertheless, for many type 2 diabetics who cannot manage glucose through traditional means, these procedures can drastically improve or even normalize blood sugar.
Is Metabolic Surgery a Definitive Cure for Type 2 Diabetes?
While metabolic surgery can resolve type 2 diabetes in many cases, it is not a magic solution. Lifelong lifestyle changes, consistent follow-up, and compliance with medical advice are indispensable. Adequate insulin production capacity in the pancreas is crucial for lasting results. Patients who have had type 2 diabetes for less than 10 years tend to respond more favorably.
