Diabetes is now a very common disease in the urban population of India. The 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 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 for lifelong. Type 2 DM is different from type 1 as in it there is resistance against insulin in the body which results in the inability of insulin to perform its work i.e. Insulin is not able to push glucose into the cells which lead to an increased concentration of glucose in the blood and the same time cells starving for glucose.
Type 2 DM is usually treated with medicines called OHAs(oral hypoglycemic agents). Now the question is how Bariatric surgery can cure Diabetes, let’s understand what we do in Bariatric surgery.
Bariatric surgery involves a variety of operations in which we make changes in your stomach and small intestine. The operation specifically suitable for Diabetics is the Gastric Bypass operation in which we create a small gastric(stomach) pouch out of the native stomach and connect it with the small intestine(jejunum).
This new arrangement in the body results in the exclusion of the Duodenum and proximal jejunum from the food pathway(food doesn’t go into the initial part of the small intestine). This leads to the secretion of incretin hormones and decreased secretion of anti-incretin hormones.
Incretins are good hormones that work like insulin and help in the control of blood sugar. So this sugar control after Bariatric surgery is
weight-loss independent, which 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 the resolution of Diabetes is that after bariatric surgery(gastric bypass) food enters early into
the last part of the small intestine(terminal ileum) which results in incretin hormone secretion and sugar control.
So the 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 gets cured by this surgery along with the attainment of
normal weight and other health benefits of Bariatric surgery.