Diabetes surgery is a new modality of treatment of diabetes. A considerable increase in interest in diabetes surgery is seen but the issue, is still controversial. Surgery for diabetes is a very radical departure from the current standard medical treatment for it.
Several studies have been done to assess the effectiveness of diabetes surgery (bariatric surgery) in controlling blood sugar levels. Results of some of these studies indicate that bariatric surgery can induce long-term remission of type 2 diabetes. According to some reports several patients on medications to control blood sugar, (and often with poor blood sugar control) have become normoglycemic (that is the blood sugar level has normalized) after the surgery. In most patients the blood sugar control has not been transient. Good control of diabetes decreases the risk of other complications of diabetes as well. However in most of the studies bariatric surgery was done in obese diabetic patients (Body mass index > 35kg/m2). The exact risk-benefit ratio of diabetes surgery is not known. Some surgeons have started to operate on less obese patients with diabetes for better blood sugar control. But the benefits of surgery in less obese people is not exactly known.
The exact way by which bariatric surgery leads to improved blood glucose control is not known. Probably after the surgery a change in hormone signaling from the small bowel occurs which leads to improved blood sugar control. Surgery is a novel way of treatment of diabetes and it appears as a promising therapeutic option. Besides this it will probably help the researchers to better understand the pathophysiology of this disease. Hence there is a lot of interest in bariatric surgery for diabetes.
But before bariatric surgery becomes a accepted treatment for diabetes ---more research will be needed to show it effectiveness.
Dr Poonam Sachdeva, our in-house medical expert talks about the why what and how in diabetes.