Obesity implies increased body fat such that it threatens the health, and recently, it is globally recognized as a disease that should be struggled. Excess weight is associated with many health problems, especially type 2 diabetes mellitus. Overweight is diagnosed in four of every five patients with type 2 diabetes mellitus. Metabolic surgery is the forefront method that offers successful results in treatment of obesity-related type 2 diabetes mellitus. Prof. Gökhan Yağcı, M.D., from Obesity and Metabolic Surgery Department of Güven Health Group, informs about metabolic surgery, obesity and Type 2 diabetes mellitus.
Glucose in bloodstream can seriously damage the tissues or organs.
Diabetes, also called high blood glucose, is caused by insufficient production of insulin – a hormone that regulates transfer of glucose from bloodstream to cells- by pancreas and resultant elevation of blood glucose. Since glucose cannot be carried to cells, it stays in bloodstream, travels around the body and may lead to serious harms, even including loss of vital tissues or organs. There are two types of diabetes: type I and type II. Pancreas cannot produce insulin in Type 1 diabetes mellitus. However, in Type 2 diabetes mellitus, pancreas produces insulin, but it cannot be used due to resistance that has developed in cells.
Overweight should be regarded as an important health problem rather than a simple aesthetic concern.
Prevalence of obesity is quickly increasing all around the world. It is ever increasingly difficult to get on with overweight, as leanness is, recently, idealized, overweight people face problems in finding appropriate size of clothes and choosing a seat in bus and even serious domestic problems are experienced. Even if the person experience no trouble with overweight, getting out of breath after ascending stairs even for one floor or difficulty in bending forward to tie shoelaces and each button that cannot be buttoned up will remind the necessity to lose weight.
Metabolic surgery not only provides a solution for obesity, but it also leads to useful hormonal changes.
Although obesity is independent from diabetes, most patients with type 2 diabetes mellitus complain of excess weight. More importantly, obesity surgery is based on diverting the digestive tract and it enables loss of excess weight along with the cure of type 2 diabetes mellitus based on useful hormonal changes. Obesity surgery is carried out to help obese patients lose excess weight and increase quality of life, and it is also called “obesity and metabolic surgery”, as it offers a solution to co-existing diseases of obese patients with metabolic disorders, such as type 2 diabetes mellitus.
Patient selection is utmost important regarding the success of treatment.
Basic principle of obesity and metabolic surgery is based on making the patient eat less by reducing the gastric reserve. This surgery intends curing high blood glucose and other metabolic diseases, if any, in patients with Type 2 diabetes mellitus along with the overweight. Thus, patients are provided with a healthier life in the long-term. Despite all these positive effects, not all patients are good candidate for obesity and metabolic surgery. Age, physical status and healthy history of patient play a significant role in successful result of the surgery. Patients are assessed by a multidisciplinary team that consists of surgeons who are specialized in treatment for obesity, endocrinologists and dieticians in order to determine whether the metabolic surgery is indicated for the patient or not. If the patient has a co-existing condition, physicians of other disciplines can be involved in this assessment.
“Class III obesity” refers people with BMI – body mass index is a value that estimates amount of fat in body – above 40 kg/m2. Metabolic surgery is an appropriate treatment option for such patients and “class II obese” patients, whose body mass index is 35.0-39.9 kg/m2 and blood glucose cannot be controlled by medical treatments. Moreover, metabolic surgery becomes an option, if high blood glucose cannot be regulated by medication treatment, including oral or intramuscular insulin and BMI of the patient with Type 2 diabetes mellitus is 30-34.9 kg/m2.
The patient should be closely monitored by specialist physicians after the procedure.
If laparoscopic method is used, metabolic surgery offers quicker resilience and more aesthetic results. Patients should be closely followed up by a multidisciplinary team that consists of endocrinologists, surgeons and nutrition experts with special experience in diabetes, until optimal results are obtained after the metabolic surgery.
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