Bariatric surgery is more than a weight loss op

Bariatric surgery, which is also termed as metabolic surgery, can make tremendous influence on the course of diabetes.

By Staff Reporter

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Published: Sat 21 Jun 2014, 9:26 PM

Last updated: Tue 7 Apr 2015, 8:56 PM

Bariatric surgery has been in vogue for so many years, but still most people are unaware of its therapeutic aspect, says Dr Uday Shankar, Specialist General Surgeon, Zulekha Hospital, Dubai.

Bariatric surgery, which is also termed as metabolic surgery, can make tremendous influence on the course of diabetes which has been so far considered to be chronic, incurable and labeled to be one which can be controlled only. There are a long list of diseases, which obese people suffer from like diabetes, hypertension, hyperlipedemia, PCOD, sleep apnea and other endocrinal disorders, which can be resolved with the help of bariatric surgery.

The most common form of diabetes which accounts for 95 per cent of all cases is T2DM. T2DM leads to many health problems including cardiovascular disease, stroke, blindness, kidney failure, neuropathy, amputations and impotency.

Current therapy for T2DM includes lifestyle intervention and anti-diabetes medications. According to Dr Uday Shankar, anti-diabetic medication may help to keep blood sugar levels from being excessively high but it offers nothing as far as resolution is concerned and disease keeps progressing. This disease often worsens with time, requiring either higher doses or increased number of medications. Most of the complications related to diabetes are related to the microvascular changes which diabetes induces in essential organs. Microvascular changes are directly proportional to number of years patient is suffering from diabetes.

Bariatric surgery could be the most effective treatment for obese patients with T2DM.

The International Diabetes Federation (IDF) after consultation with diabetologists, endocrinologists, surgeons and public health experts around the world released a position statement calling for bariatric surgery to be considered early in the treatment of T2DM. Surgery should be an accepted option in people who have T2DM and a BMI of 35 or more. Surgery should also be considered as an alternative treatment option in patients with a BMI between 30 and 35 when T2DM cannot be adequately controlled by optimal medical regimen, especially in the presence of other major cardiovascular disease risk factors like hypertension and hyperlipedemia.

Gastric Bypass & Sleeve is a routinely performed surgery. This procedure is done laparoscopically with minimal pain and requires one or two days of hospital stay. The recovery after surgery is swift. Most of the patients can go back to work after a week or two. The operation results in significant weight-loss and causes remission of T2DM. A total of 80 per cent of patients do not require any medication for diabetes after surgery. There is considerable improvement in an additional 15 per cent of patients where the need for medication is bare minimal. It also helps in resolution or improvement in diseases like hypertension and lipid abnormality.

Bariatric surgery has been proved to be cost- effective treatment for T2DM. The risk for complications and death is low and similar to that of any other well-accepted laparoscopy procedures.


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