Diabetes mellitus is caused due to non-functioning INSULIN hormone released by ß (beta) cells in pancreas.
– Less secreted
– Secretion is impaired
– The hormone is ineffective in the body, that means it is produced in the pancreas but does not function, insulin resistance has occurred. Diabetes mellitus is a chronic disease that causes systemic disorders affecting the whole body.
Diabetes mellitus rate is increasing every year in the world.
Diabetes mellitus is divided into two as Type 1 and Type 2.
Type 1 diabetes mellitus is observed in young people. Genetically caused by beta cell damage in the pancreas, it is a form of diabetes that is usually insulin-dependent from the start, unrelated to obesity. In this diabetes type, insulin is definitely required.
Metabolic surgery does not need to be performed in the treatment of this type of diabetes.
If body of the patient release insulin but does not use it or if it releases less insulin, it is called Type 2 diabetes mellitus. It is a type of diabetes, seen generally in 25-year-old or older people. Type 2 diabetes can also be categorized within itself.
GROUP 1 – This is the condition of patients with severe insulin deficiency. They do not have insulin in their bodies.
GROUP 2 – Patients with severe insulin resistance, insulin is produced but the body no longer responds to it. These patients are obese. Excess body fat is the main problem
GROUP 3 – Moderate obesity-associated diabetes, usually in very overweight people,
GROUP 4 – At older ages and with a more moderate course of the disease. In this case, there is destruction of the cells that make insulin.
The function of the pancreatic gland in patients is measured by the C-peptide level.
Especially group 2 and group 3 TYPE 2 DIABETES MELLITUS patients are overweight. These patients with a body mass index of 30 and above may benefit from METABOLIC SURGERY operations if their c-peptide level is acceptable.
Blood sugar levels of 70-110 mg/dl is normal. Hemoglobin A1c shows the blood glucose level for the last 3 months. This should be less than 6%. Above 6% means high blood sugar levels.
Healthy Diet:
It is important to choose low-carbohydrate, low glycemic index carbohydrates. White flour, sweets and rice are foods to be avoided. Oats are the preferred carbohydrate.
Exercise:
Exercise helps to break insulin resistance and burn fat by exerting energy. At least 45 minutes of exercise 4 days a week is recommended.
Medication / Insulin:
Insulin is a hormone produced by the pancreas that lowers sugar by causing sugar to enter the cell. In case of ineffectiveness or deficiency, it can be added externally to the treatment.
It is available in tablet or injection forms.
* Diabetic ketoacidosis with coma
* Hyperosmolar nonketotic coma
* Lactic Acidosis and
* Hypoglycemic coma
* Retinopathy (eye damage),
* Neuropathy (nerve damage) and
* Nephropathy (kidney damage).
* Large blockages in blood vessels are also quite common. Problems such as stroke, embolism may occur.
*Wounds on the feet of diabetics are delayed in closing because the vascular and nervous system is impaired.
The skin is dry, coronary cardiac disease, paralysis, stroke, cerebral hemorrhage, leg embolism called peripheral artery disease may be seen.
At least of the followings:
⦁ Diabetes mellitus or
⦁ Impaired glucose tolerance or
⦁ insulin resistance
Metabolic syndrome decreases life quality and shortens lifetime like smoking, and is a preventable cause of death. Therefore, it is essential to be treated.
In particular, a lack of GLP-1 secreted from the ileum, the last 1.5 meters of the small intestine, which is 7 meters on average, can cause diabetes. Our PURPOSE in surgery is to increase the functionality of this particular body part. With bypass surgeries, food bypasses the first part of the small intestine and reaches directly to the middle parts.
Type 2 diabetes mellitus patients benefit from metabolic surgery. Patients with a body mass index above 30 and normal c-peptide levels are eligible for this operation.
But it should be noted that every type 2 diabetes patient is not a candidate for surgery.
Metabolic surgery is a surgery that results in a change in the metabolism of the person and leads to an increase in certain hormones in the body.
Gastric sleeve surgery and gastric bypass surgeries are based on restriction and malabsorption. Patients undergoing bypass surgeries where malabsorption is at the forefront need to take iron, calcium, vitamin and mineral supplements for life.
In our clinic, we perform surgery on patients with obesity and moderate to severe diabetes:
One-anastomosis (Mini) Gastric Bypass (OAGB) and gastric sleeve surgery.
