Type-2 Diabetes, also known as adult-onset diabetes, happens when your body does not use insulin produced efficiently. Your body resists the effects of insulin. Initially, your pancreas produces extra insulin to compensate for it. However, over time, it is not able to keep up and produce enough insulin to maintain your blood glucose at normal levels.
Around 95 per cent of people who are diagnosed with diabetes have Type-2 Diabetes.
How Do I Know If I Have Type-2 Diabetes?
Type-2 Diabetes is often diagnosed in adults. If you experience any of these symptoms, do consult the doctor immediately:
Feeling very thirsty
Extreme fatigue and weakness
Unintentional weight loss
Constant hunger and weight loss
Slow-healing wounds or frequent infections
Dry and itchy skin
Patches of darkened skin
What Causes Type-2 Diabetes?
In people without diabetes, insulin controls the blood glucose level. Insulin is released to move glucose in the bloodstream into your cells to produce energy for daily activities.
In type-2 diabetes, insulin is not used properly. Glucose accumulates in your bloodstream instead of moving into the cells. Due to the increased glucose level, the beta cells in your pancreas produces more insulin. Eventually, these cells are not able to produce enough insulin for the body’s needs. This causes damage in many parts of your body and cells do not get enough energy to function.
Type-2 Diabetes can be caused by environmental factors such as a sedentary lifestyle, being overweight or obese and eating too much or too much junk food. This means that you are able to lower your risk of Type-2 Diabetes by maintaining a healthy weight, making changes in your diet and leading an active lifestyle.
Why Bariatric Surgery For Type 2 Diabetes?
Traditionally, modifications to an individual’s current lifestyle to lose excess weight, such as eating a healthy and reduced calorie diet and engaging in regular physical activity are the first-line of treatment for Type-2 Diabetics. Medications may also be prescribed to curb your diabetes. This is achieved through helping your pancreas produce more insulin or helping your body to use the insulin it produces in a more efficient manner. You may also have insulin injections.
However, medical therapy often falls short in the long-term. If you have been having Type-2 Diabetes for many years, lifestyle changes and medications may not work anymore. A major possibility is that your cells which produce insulin may be worn out from having to produce extra insulin to overcome insulin resistance over a long time. Patients are thus placed at a risk of medical complications in the long run. These include blindness, kidney failure, heart and blood vessel disease, amputations,
stroke and cardiovascular disease caused by diabetes. It is important to recognise that while medications may curb your diabetes for a certain period, in many cases, medical therapy is not a life-long solution for diabetes. This is where bariatric surgery is highly recommended and even essential.
Bariatric, or metabolic surgery plays a major role in treating Type-2 Diabetes. This is achieved through both weight loss as well as ameliorating diabetes independently of weight loss. Bariatric surgery can cause the improvement and remission of Type-2 Diabetes for many years.
Sustained weight loss
By removing parts of your stomach (Laparoscopic sleeve gastrectomy) and rerouting the small intestine (Laparoscopic roux en y gastric bypass), bariatric surgery results in greater and sustained weight loss than conventional methods in the majority of patients. This in turn leads to
improvements in the quality of life and obesity-related diseases such as hypertension and sleep apnea amongst many others.
Eliminate need for medication
Bariatric surgery has shown to effectively eliminate the need for diabetes medications in some patients and drastically reduce the need for drug treatment in others if performed early.
Reversal and remission
Surgery completely reverses or improves Type-2 diabetes in around 86 per cent of patients by lowering blood sugar levels and heightening insulin sensitivity, with a drastic reduction in insulin levels. This decreases the required dosage and type of medication and improving health problems related to diabetes.
Surgery causes remission in Type-2 Diabetes in around 78 per cent of individuals by reducing blood sugar levels to normal levels, eliminating the need for diabetes medications and improving health in general.
Lowered risk of related diseases
Studies have demonstrated that among patients who have undergone surgery, the risk of cardiovascular disease decreased, allowing reductions in therapies aimed at hypertension and lowering lipid levels. These improvements may potentially reduce morbidity and mortality caused by cardiovascular diseases.
In addition, high blood pressure was improved in 78 per cent of patients who undergone surgery and high blood lipids in more than 70 pre cent of patients.
When Should I Undergo Bariatric Surgery?
Studies have found that the shorter a person’s history of diabetes, the higher the possibility of complete remission. In poorly-controlled diabetes, glucose toxicity accelerates beta cells failure to function, which means your beta cells are no longer able to produce and secrete insulin. By helping you lose weight, bariatric surgery can improve your beta cells’ responsiveness to glucose.Sustainable weight loss will be accompanied by good chances of long-term remission. It is highly important for the procedure to be performed prior to failure of beta cells as this condition is irreversible.
Simply put, the earlier you choose to undergo surgery, the better the outcome.
Who Should Undergo Bariatric Surgery?
Latest research has shown that bariatric surgery is not just for diabetics who are severely overweight, but can also be used as treatment for diabetics who are of normal weight or are moderately overweight. This is because bariatric surgery does not only work via reduction in an individual’s body weight but also has other positive effects on your health and body, such as rapid heightening of insulin sensitivity and lowering of blood sugar levels. These occur in the immediate period even before significant weight loss has occurred and are the basis of diabetic treatment.
More than eight in ten diabetic patients of normal weight have achieved diabetes improvement within a week to three months post-surgery. Similarly, more than 85 per cent of diabetic patients who are obese have achieved diabetes improvement through surgery.
In addition, bariatric surgery also plays an important role in preventing diabetes in obese patients who are not diabetic. If you are severely overweight but not diabetic, weight loss after surgery decreases your chance of developing diabetes by 60 per cent.
How Does Each Procedure Work?
Both laparoscopic roux en y gastric bypass and laparoscopic sleeve gastrectomy work through four main ways as follows:
Rapid and significant weight loss
Alteration of gut hormones which affects how your body produces and secretes insulin
More efficient usage of insulin which lowers blood sugar levels
Increased amount of bile acids produced by your body, which increases your cells’ sensitivity to insulin
More specifically, Laparoscopic roux en y gastric bypass is a surgery to change your gastrointestinal tract. By causing food you consume to bypass most of the stomach and the upper part of your small intestine, this surgery improves diabetes through rapid and significant weight loss. Independently
of weight loss, Roux en y gastric bypass also alters the production of various hormones produced by your gut, which leads to improvement of insulin secretion and resistance. Furthermore, the surgery improves the way your cells use insulin, lowering your blood glucose levels. The amount of
bile acids that your body produces is also increased, increasing your body cells’ sensitivity to insulin.
Laparoscopic sleeve gastrectomy is a surgery which removes a large portion of your stomach. In doing so, this helps you lose weight rapidly. With a narrow remaining stomach, there is much less space for food. You will only be able to consume smaller amounts of food after the surgery.Laparoscopic sleeve gastrectomy also has mechanisms to treat diabetes independent of weight loss. It leads to changes in hormones produced by your gut. This in turn affects how your body produces insulin which leads to an improvement in diabetes. Furthermore, the surgery improves the way your cells use insulin, lowering your blood glucose levels. The amount of bile acids that your body produces is also increased, increasing your body cells’ sensitivity to insulin.
Dr. Ganesh Ramalingam
Specialist in General Surgery
As a strong proponent of treating the patient holistically instead of just their condition, Dr Ganesh Ramalingam advises patients as to how they can manage their daily habits and diets to lead healthier lifestyles. As a consultant with G&L Surgical Clinic specialising in General Surgery, he sees many patients with conditions related to the stomach and is skilled in bariatric surgery, upper GI and hernia surgery, advanced laparoscopic surgery, endoscopies, and trauma.
G&L Surgical Clinic will do our best to provide you with an estimate of your out-of-pocket expenses before your procedure. With a comprehensive financing service, we endeavour to assist you in finding the most suitable financing option to enjoy a seamless and pleasant experience. Please do not hesitate to contact us with any questions. We are here to help you get the care you need.