Diabetes Surgery

Diabetes Surgery (Metabolic Surgery)

In recent years, the term “bariatric surgery, treats diabetes” has spread unexpectedly. Opinions come and go, and it is no wonder, since we are dealing with DIABETES, which along with obesity, are considered the giants of diseases in this century, and the number 1 causes of morbidity and death among the population. . DIABETES SURGERY Diabetes surgery, also known as metabolic surgery, is a series of surgical procedures intended to treat diabetes. It includes procedures such as bypass, mini-bypass, SASI type bypass, gastric sleeve, among others. Metabolic surgery is a reality based on serious scientific publications and prestigious institutions in the world. Metabolic surgery is one of the most important medical discoveries of the century. IS THIS SURGERY FOR WEIGHT LOSS OR FOR THE TREATMENT OF DIABETES? The specific answer is, metabolic surgery can act both in weight loss and in normalizing glucose levels. From 1954, when Dr. Linner first performed this surgery, until the early 90's, these surgeries were intended to treat obesity only. However, in the early 90's, Dr. Pories in the United States and Dr. Scoppinaro in Italy realized that when performing surgery on diabetic patients with obesity, glucose levels normalized and the patients stopped consuming medicines. At first, it was believed that this effect on diabetes was produced by weight loss, however subsequent research has concluded that the effect that surgery has on diabetes has several explanations and NOT ONLY weight loss, as such way that surgery for diabetes can work in people with or without obesity. HOW DOES METABOLIC SURGERY WORK TO REMIT DIABETES? It is currently known that surgery is capable of achieving DIABETES REMISSION, even before weight loss occurs. This is due to several mechanisms, some of them not yet clearly explained. Among the most important mechanisms are the following: 1.- It is capable of increasing the production of hormones in the final part of the intestine, such as GLP1, PYY, Leptin, these hormones have an effect on glucose metabolism, in other words. , can cause glucose to enter cells, which reduces its levels in the blood. In addition, they also produce the release of insulin in the pancreas and reduce insulin resistance. In some studies it has also been seen that it can increase the production of pancreatic islets (they are the cells that are responsible for producing insulin). 2.- Inhibit the production of the hormone Ghrelin, this hormone is produced in the stomach and is considered a pro-diabetic hormone, that is, it increases the levels of glucagon in the blood, in other words, it does not allow glucose to eliminate from the blood properly. With surgery, Ghrelin levels decrease, therefore, a decrease in blood glucose occurs. 3.- Surgery causes food not to pass, or to “skip” the initial part of the intestine, where the largest amount of simple carbohydrates, such as glucose and fructose, is absorbed, this causes the levels of these carbohydrates to decrease in the body. 4.- Surgery has an effect on the microbiota (they are the normal bacteria that live in the intestine) and on the secretion of bile acids, this has an antidiabetic effect that has not yet been completely explained. 5.- Finally, in patients with obesity, weight loss decreases insulin resistance in the body and improves nutrition, which contributes to the normalization of glucose levels. The aforementioned effects can occur in people with or without obesity. DOES METABOLIC SURGERY CONTROL, REMIT OR CURE DIABETES? Metabolic surgery is capable of not only controlling, but also completely remission of the disease. CONTROL being understood as the decrease or normalization of glucose levels, WITH THE USE OF MEDICINES on a continuous basis. Until now, medications such as glibenclamide, metformin, insulin and the most current ones such as liraglutide, GLP-1 analogues and even insulin, are capable of controlling diabetes. On the other hand, we speak of REMISSION when, after surgery, glucose levels are normalized WITHOUT THE USE OF MEDICATIONS. The word CURE implies that after some treatment diabetes medications will NEVER be required, that is, it means that the disease, after surgery, WILL NEVER RETURN. Can metabolic surgery cure diabetes? The answer, really, no one knows. Until now we can say that surgery can achieve REMISSION, and not a CURE of the disease, and that so far, it is the most effective treatment that exists for diabetes.
SO, IF I HAVE METABOLIC SURGERY FOR THE TREATMENT OF DIABETES, WHAT IS MY PROGNOSIS? If you have already been evaluated and are a candidate for the procedure, the prognosis is very favorable. Specifically, the possibility of achieving total remission of the disease can be up to 95%. Which will significantly reduce the risk of complications such as diabetic foot, blindness, diabetic neuropathy, kidney failure and dialysis, among others. Will diabetes remain in remission for life after surgery? We do not know that answer exactly, since there are patients who underwent surgery for diabetes, and after a few years, the disease has returned, however there are others, who, after many years, still remain with diabetes. sent. We know that there are some factors that increase the possibility of diabetes remaining in remission after surgery, these are some of them: 1.- Improve eating habits, 2.- If at the time of surgery, the patient had few years with diabetes, that is, the less time there is from the diagnosis of diabetes to the time of surgery, the better the prognosis. 3.- If the pancreas is functioning well at the time of surgery, this means that the less pancreatic deterioration there is at the time of surgery, the better the prognosis. The functioning of the pancreas can be measured with some blood studies, the best known is the C peptide. 4.- Type 2 diabetes has a better prognosis than type 1 diabetes. Let us remember that not all patients are candidates for surgery, however, For candidate patients, the prognosis, in terms of diabetes remission or improvement, is very good. CAN METABOLIC SURGERY NOW BE PERFORMED? AM I A CANDIDATE? That's right, metabolic surgery is already approved in Mexico, however certain requirements, preoperative studies and evaluations are required. Not all patients are candidates for the procedure. One of the questions we answer very frequently is: If I have diabetes and I am not obese, can I have metabolic surgery? The answer is yes, but not in Mexico, not until now. Although it is already known that metabolic surgery has a similar effect in people without obesity, it is not yet approved in Mexico. However, in general terms, candidate patients are those with grade I obesity or greater, that is, if you have a body mass index (BMI) of 30 kg/m2 or greater and suffer from diabetes, you could be a candidate for surgery. You can get your BMI here http://obesityhealth.com.mx/en/obesity/. In Mexico there are already serious surgeons and institutions that perform surgery. See Dr. Rey J. Romero interview video here. RISKS OF SURGERY All surgical procedures have a percentage of risks or complications, metabolic surgery is no exception. However, in certified surgeons, with experience and with the appropriate material, the possibility of complications is less than 2%. It is also necessary to mention that complications or risks, in the rare case that they occur, can be treated and corrected. The risk of presenting a complication related to diabetes, such as use of dialysis, blindness, amputations, heart attacks, among others, is much greater than the risk of metabolic surgery. WHAT OTHER DISEASES CAN BE TREATED WITH METABOLIC SURGERY? The number of diseases that achieve remission or improvement after surgery is very high. Just to name a few, systemic high blood pressure, obesity, obstructive sleep apnea (snoring), osteodegenerative disease (chronic knee pain), hepatic steatosis (fatty liver), dyslipidemia (high cholesterol and lipids), gout (high uric acid), polycystic ovary syndrome, menstrual irregularities, gastroesophageal reflux, irritable bowel syndrome, metabolic syndrome, depression, anxiety. It is also capable of preventing the appearance of diseases such as heart attacks, diabetic foot, kidney failure and some types of cancer such as breast, cervical, colon, among others.

Diabetes Surgery Testimonials

"I no longer take insulin or medications, I invite you to do it, it is your best investment" Norma.
"I had problems with diabetes, pressure and fatty liver, 4 months after my sasi bypass, all this has been resolved" Miguel.
"I was insulin dependent before surgery" Fernando.
"I managed levels of 280 mg/dl, 5 months after my sasi bypass with bipartition, I have lost 43 kg and my levels are 70.80 mg/dl" Oscar.
"My glycosylated hemoglobin went from 6.9 to 5.4 without the use of medications" Rosa.
"One month after my surgery my glucose has already gone from 285 to 90 mg/dl without the use of medications, I feel very good" Blanca.
"I had a metabolic bypass for diabetes remission, I feel very good 24 hours after the surgery" Gerardo.
"I have said goodbye to obesity and diabetes, I am very grateful" Angélica.
"I took metformin and insulin, since I came out of surgery I haven't taken any, I'm already in grade 2 obesity, I'm halfway there" Bea.
"We came from Chicago to have diabetes surgery with Dr. Rey, the care is first class, I recommend him" Romeo.
"I consumed 3 medications a day, I had a Glycosylated Hemoglobin of 9.6 and I currently manage a Glycosylated Hemoglobin of 5.2 and I do not consume any of the medications" Imelda.
"They diagnose us with diabetes, but this surgery is something they don't tell us, it is something that changes your life" Erbey.
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