Freaquently Asked Questions
Which diabetes patients benefit from this treatment and who is a candidate for this treatment?
We treat patients with type 2 diabetes using surgical methods. This is called Metabolic Surgery. The classical treatment algorithm of type 2 diabetes is education, diet, exercise and medication use. However, despite all these treatments, the disease is sometimes progressive. Despite the intense use of insulin, desired results cannot be obtained. In this case, Metabolic Surgery should come to the agenda as an effective treatment alternative.
Do these treatment methods differ in type 1 and type 2 diabetes?
Of course. Type 1 and type 2 diabetes are completely separate diseases. There is no insulin production in type 1 diabetes. In type 2 diabetes, the body produces insulin but cannot use it. We can only help patients with type 2 diabetes. In other words, we ensure that the body uses insulin that it cannot use.
Is there a need for a method such as surgery because classical treatment methods are not sufficient in type 2 diabetes?
Type 2 diabetes is a multifactorial, heterogeneous and dynamic spectrum of diseases. It is a process in which not only hormonal but neural, psychogenic and environmental factors are also effective. The cornerstones of classical therapy are diet and exercise. However, no one can diet and exercise for whole life. In fact, the proportion of patients who can only diet and exercise at the desired level for 3 years is not above 5% in any research. Medication treatments are not intended to change the general course of the disease, but are “saving the day” treatments. If we want to effectively combat type 2 diabetes and related loss of organs and workforce in appropriate patients, we need to apply more radical but rational treatments.
Is the most radical and rational treatment Metabolic Surgery?
In fact, the most radical and rational treatment is to manipulate the food industry, our city planning and the automotive industry. The problem is in food and lifestyle. However, at this stage, I do not think that any person, institution or even the government can go to such a sanction.
So, what effect does surgery have on this situation?
As modern age people, we could not adapt to the food industry and industrial metropolitan life. The contents of the foods we eat have changed over the past 25 years. Now almost everyone living in developed cities consume refined, that is, processed foods. When these foods reach the middle part of the small intestine, they are digested biochemically. Very low pulp of nutrient content is remained. Insulin resistance hormones are secreted from the initial part of our small intestine and insulin sensitivity hormones from the last part. As the final nutrient content becomes poor, the sensitivity of the hormones decreases. We activate the insulin sensitivity hormones by replacing the beginning and end of the small intestine in surgery.
How does blood sugar consistently affect the organs in our body?
Both diabetes types cause organ damage by damaging the vessel wall. Organ damage varies depending on which type of vein is affected in which localization. In patients with weight problems, it usually causes medium- and large-sized vessels and related problems such as heart attack and stroke. In patients with lower weight, it usually affects small- and medium-sized vessels, and manifests itself with problems such as eye, kidney and feet problems. However, there are certainly exceptions.
At which stage do you suggest surgery?
In type 2 diabetes, medium- and large-scale vascular damage begins before the disease is diagnosed. Already, a significant number of patients are considered to have a 2-3 year history of disease at the time of diagnosis. Imagine, as soon as you get a diagnosis, you already have an impact on your veins. However, type 2 diabetes generally has a moderate course. So, a significant part of the complications gradually manifest over the years. For this reason, it is also defined as “insidious” disease.
In the follow-up of a type 2 diabetes patient, it is generally accepted to consume their own insulin reserves over a period of 10-12 years, and after this period, signs of organ damage begin to manifest themselves. This is the period when patients generally apply for treatment. Most patients do not want to have surgery while things seem to be fine. In summary, in order for us to help a diabetic patient with surgery, they should either not be able to control their sugar with standard treatments or have signs of organ damage. Of course, applying without loss of organs and before the insulin reserves are exhausted has many positive consequences.
How is the surgery decision made?
The most important thing is to make sure the patient has type 2 diabetes. However, this is not enough. There must be a certain level of insulin reserve function and activity. Plus, insulin resistance hormones originating from adipose tissue must be positive and substances that damage insulin-producing cells must be normal. Of course, the most important thing is that the patient cannot control blood sugar or other metabolic syndrome components.
Does this condition of a person with diabetes disappear in the postoperative period?
It is their own reserve and activities that determine the extent to which a type 2 diabetes patient will benefit from this surgery. The more insulin reserves available and the higher the activity, the higher the chances of success. However, the most important point to remember is that diabetes has hormonal, nervous and psychogenic bases. These surgeries only treat the hormonal aspect of diabetes. There will be a fluctuation in blood sugar when a patient with whom you provide hormonal control with a very crude expression is upset, delighted, angry for any reason. In fact, such fluctuations occur in individuals without diabetes.
However, the duration and severity of the fluctuation are smaller in non-diabetic patients. After the operation, this fluctuation will be lighter and will return to normal in a shorter time. Type 2 diabetes is a dynamic disease with a variational course over time. The important thing is the 3-month average blood glucose values and the presence of organ damage. From this point of view, more than 90% of patients will be controlled over a 10-year period
Are medication use or insulin use coming to an end, and if so, is it a temporary or a whole life?
It is their own reserve and activities that determine the extent to which a type 2 diabetes patient will benefit from this surgery. The more insulin reserves available and the higher the activity, the higher the chances of success. However, the most important point to remember is that diabetes has hormonal, nervous and psychogenic bases. These surgeries only treat the hormonal aspect of diabetes. There will be a fluctuation in blood sugar when a patient with whom you provide hormonal control with a very crude expression is upset, delighted, angry for any reason. In fact, such fluctuations occur in individuals without diabetes.
However, the duration and severity of the fluctuation are smaller in non-diabetic patients. After the operation, this fluctuation will be lighter and will return to normal in a shorter time. Type 2 diabetes is a dynamic disease with a variational course over time. The important thing is the 3-month average blood glucose values and the presence of organ damage. From this point of view, more than 90% of patients will be controlled over a 10-year period
Is there an age limit in obesity surgery applications?
Patients must have completed the adolescence period for the implementation of obesity surgery. There is no upper age limit which is restrictive for these surgical procedures, but patients who will be operated with one of the advanced methods of obesity surgery should have good general health and no chronic diseases.
Did you Know?
- Approximately 463 million adults (20-79 years) were living with diabetes; by 2045 this will rise to 700 million.
- The proportion of people with type 2 diabetes is increasing in most countries
- 79% of adults with diabetes were living in low- and middle-income countries
- 1 in 5 of the people who are above 65 years old have diabetes
- 1 in 2 (232 million) people with diabetes were undiagnosed
- Diabetes caused 4.2 million deaths
- Diabetes caused at least USD 760 billion dollars in health expenditure in 2019 – 10% of total spending on adults
- More than 1.1 million children and adolescents are living with type 1 diabetes
- More than 20 million live births (1 in 6 live births) are affected by diabetes during pregnancy
- 374 million people are at risk of developing type 2 diabetes
Diabetes, otherwise known as the sugar disease, is common and causes serious results. Diabetes is a disease caused by conditions such as a sedentary lifestyle, an unbalanced diet, and genetic factors.
Diabetes Surgery is the treatment of diabetes by surgery. You do not need to have serious weight problems to benefit from these surgeries. What is important is that you are a diabetes patient whose body still produces insulin but cannot use it (Type 2 diabetes).
Diabetes Surgery treats the cause of the disease. When the cause is eliminated, the blood glucose level will return to normal. With Diabetes Surgery, the hormones of your digestive system change. As a result, your perspective on food and your appetite will change.
The first clinical data that shows that diabetes can be treated surgically in individuals without serious weight problem was collected in 2003. It has been implemented in our country since 2008. The success rate of medication or insulin is under 20 percent. The common result of all studies comparing surgery and other methods (medication, insulin and lifestyle) is that surgery is clearly more successful in the long run.
