What is Metabolic Surgery?

Metabolic surgery, also known as diabetes or sugar surgery among the people, includes surgeries that allow both diabetes and obesity to be controlled at the same time. Diabetes, also known as diabetes, is divided into Type I and Type II. Type II diabetes, in which insulin is produced in the body but ineffective, is often associated with obesity. Insulin resistance is seen in Type II diabetes, which is seen in an average of 90% of people with diabetes worldwide. In healthy people, the person feels hunger and eats with a hormone secreted from the stomach. When the stomach wall stretches with the food he eats, as a result of the stimulus to the brain, the stomach stops secreting hormones and the person begins to feel full. At this time, food begins to pass into the intestines and be digested and absorbed. In healthy people, undigested foods can easily reach the last parts of the small intestine. Undigested foods cause the glp-1 hormone to be secreted from here. This hormone provides more active insulin release from the pancreas and blood sugar is controlled. However, obese people have a larger stomach and more hunger hormone secretion. These people increase their portions or have to eat more often to feel full. In addition, the size of the intestine and the number of villi that provide food absorption increase even more in obese people. Thus, undigested food cannot reach the last part of the bowel intestine and the glp-1 hormone cannot be activated. As a result, blood sugar begins to rise because the insulin in the pancreas cannot be actively released. With the effect of insulin resistance, patients' blood sugar rises excessively. As a result, diabetes begins. Medicines, diet and appropriate exercises are generally used in the treatment of type II diabetes. However, in some cases, these treatments are not sufficient and the disease progresses and brings different diseases such as cardiovascular diseases, stroke, kidney and foot disorders and vision loss. In some patients, the desired results cannot be achieved despite intensive use of insulin. In type II diabetes, medications and other treatments are used to control the disease, not to cure it completely. However, today, more precise results can be obtained in the treatment of type 2 diabetes by applying metabolic surgery procedures in suitable patients. Thanks to metabolic surgery, insulin produced in the body but not showing any effect is used. At the same time, with the improvement of other diseases caused by diabetes, the life expectancy of patients is prolonged and their quality of life increases.

Who can have Metabolic Surgery?

Metabolic surgery is not suitable for all types of diabetes. These surgeries have no effect on patients with type I diabetes. In order to benefit from metabolic surgery, the body needs to produce insulin, albeit in a small amount. In this sense, different treatment methods are applied in Type I diabetes where there is no insulin production. Type II diabetes patients, who make up the majority of diabetics, are the most suitable candidates for metabolic surgery. However, since insulin production in the pancreas may have decreased in diabetic patients over 10 years old even if they have type 2 diabetes, it is necessary to measure the insulin level in the pancreas before metabolic surgery, even if the person has type 2 diabetes. For this, the level of C-peptide substance, which is the precursor of insulin in the pancreas, is checked with a blood test. According to the World Health Organization data, approximately 90% of these patients are also overweight. Body mass index is also of great importance in patient selection. To benefit from metabolic surgery, patients must have a body mass index above 35. Patients who do not respond to medical Type II diabetes treatment and whose mass index is above 30 may also have metabolic surgery.

How is it performed?

Today, thanks to developing medicine, metabolic surgery is performed in a closed manner. Operations, which are usually performed by opening 4-6 small incisions, are performed with different methods. The common feature in all surgeries is to intervene in the stomach, reduce appetite and restrict food intake, and additionally make shortcuts that will allow food to reach the last part of the small bowel.

What are the risks of metabolic surgery operations?

There are some risks seen in every operation after metabolic surgery operations. The risk of bleeding is approximately 0.9%, clot problems 0.3%, stenosis problems 0.3%, the probability of leakage is 1-2%, less frequently anesthesia-related problems that may occur in every surgery, and very rarely (0.2%) Death of patients is among the risks of surgery. However, depending on the type of surgery performed, there are risks such as hernia, diarrhea, vomiting, ulcer, reflux and intestinal obstruction in the long term. However, these risks are seen in a relatively small group of patients. The average success rate of surgeries is 95%.

FAQ

Is metabolic surgery the definitive solution for Type II diabetes?

Type II diabetes patients need lifelong medication, insulin supplementation, diet and exercise. However, for many years, most patients do not comply with these rules. Continuous and regular treatment also reduces the quality of life of patients. In this sense, metabolic surgery methods, which have been highly successful, produce different results from patient to patient. Most patients abandon insulin supplementation completely after these methods. In this sense, metabolic surgery methods provide a definitive solution in these patients. In some patient groups, it is necessary to continue medical treatment by reducing the postoperative drug doses much more. Although treatment is continued with medication after surgical methods, weight loss is ensured, possible diseases are prevented and blood sugar is kept under control.

What should be considered after metabolic surgery operations?

Although these operations give effective results in most diabetes patients, patients also need to make changes in their lifestyles and eating habits in order to increase the success rate. In this process, which also has psychological effects, it is beneficial to get help from psychologists as well as dietitians and general surgeons.

How long does it take for patients to recover after the surgery?

Patients are fed only with liquid foods for 2-3 days after the surgery. Patients who are discharged from the hospital in an average of 4-5 days, if they work at a desk job, can return to their work after the first week and to their daily lives after the first month. However, it is necessary to be under the control of a doctor in a process spanning about 2 years.

Who cannot have metabolic surgery?

Some patient groups cannot benefit from metabolic surgical operations applied to type II diabetes patients. Metabolic surgery is not applied to people with a body mass index below 30, people who do not have enough insulin in the pancreas, patients with severe psychiatric illness, and patients with organ function losses due to diabetes.