A cure for diabetes in obese people: metabolic surgery. effective?

According to Riskesdas data compiled by the Ministry of Health in 2013, approximately 12 million Indonesians are known to have diabetes. This figure is estimated to increase to 21.3 million in 2030.

One of the biggest risk factors for diabetes is obesity. More and more fat reserves in the body will interfere with the work of insulin to control blood sugar levels, thus making the body resistant to insulin. Insulin resistance increases your risk for diabetes. Living a healthy lifestyle, regular exercise, and taking diabetes medications such as metformin are the main keys to controlling diabetes risk. But there is one other alternative that can be used as a cure for diabetes in obese people. Recommend, metabolic surgery.

What is metabolic surgery?

Metabolic surgery is a gastrointestinal surgery whose concept was developed from bariatric surgery for obese people. According to American Society for Metabolic and Bariatric Surgery and supported by other studies, this operation is most effective in treating severe obesity.

One type of bariatric surgery focuses its procedure on cutting a portion of the small intestine, which is called a bowel bypass. This action is done by combining the upper part of the stomach with the small intestine, so that your stomach is full quickly and not many calories are absorbed from food.

Cutting part of the small intestine is reported to control symptoms of type 2 diabetes such as hyperglycemia. This surgery can also reduce the risk of other diseases such as sleep apnea and certain cancers that may appear as a package of metabolic syndrome, due to high blood sugar and cholesterol levels, as well as excess belly fat from obesity that you have.

The benefits that can be obtained from metabolic surgery as a drug for diabetes in obese people

After undergoing metabolic surgery, the patient's glycemic control was reported to be better and lasted between 5-15 years. This results in 30-63% of patients experiencing diabetes remission.

This better glycemic control is due to the weight loss that occurs after surgery. Weight loss will increase insulin sensitivity and increase insulin secretion. In addition to changes in gastrointestinal hormones, bile and fat metabolism also play a role in weight loss.

In addition to better glycemic control, studies have shown a reduced risk of cardiovascular disease and an improved quality of life in patients who have undergone this surgery.

Who can undergo metabolic surgery?

Maybe you consider yourself fat and are interested in having metabolic surgery. But unfortunately, there are several conditions that must be met if you want to take this medical procedure, namely:

• Has a body mass index of more than 40 kg / m². This operation will only be performed on people who have a very fat body.
• Has a body mass index of more than 35 kg / m² if blood glucose remains high (hyperglycemia) after lifestyle changes and optimal medication therapy.
• Has a body mass index of 30.0-34.9 kg / m² if hyperglycemia is not controlled with oral or injectable drugs (including insulin)
• Obesity accompanied by certain chronic diseases such as type 2 diabetes or high blood pressure
• Committed to adopting a healthy lifestyle after successful metabolic surgery and having regular checkups with a doctor.
• Dare to take risks that might happen.

If you have all the requirements above and are interested in taking this action as a medicine for your diabetes, you should consult your doctor first.

What are the risks of this surgery?

Metabolic surgical procedures can be performed using laparoscopy, so that major surgical risks can be avoided. Metabolic surgery is classified as a medical procedure with minimal risk of death; only 0.1-0.5%. As low as surgical cholecystectomy (removal of the gall bladder) or hysterectomy (removal of the uterus)

But even though it sounds promising, this surgery has various risks and side effects that may occur. The most common are deficiencies of certain nutrients. The reason is, changing the shape of the digestive organs can cause your body not to absorb nutrients optimally. This vitamin and mineral deficiency condition can be easily treated with dietary supplements

The risk of hypoglycemia (low blood sugar) is rare, but not impossible. This is caused by an increase in insulin or known as hyperinsulinemic hypoglycemia . People who have had this surgery show an increase in excessive insulin secretion after eating food.

The ADA advises you not to have this metabolic surgery if you have a history of alcoholism, drug abuse, major depression, suicidal tendencies, or other mental health conditions. Operations may only be carried out when these conditions are addressed.

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