Metabolic Surgery

Metabolic Surgery
Metabolic Surgery
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In the last half of the 20th century, experiments were conducted to see if diseases such as high lipid and cholesterol could be treated with surgical procedures such as intestinal bypass.

In 1995, Dr. Walter Pories and his research team said, “Who would have thought that? For adult onset diabetes mellitus, surgery has proven to be the most effective treatment ”. Since this landmark article, a great deal of evidence has gathered to show that surgery can cure / ameliorate a variety of metabolic diseases, particularly adult-onset or Type 2 diabetes mellitus.

In 2009, the American Bariatric Surgery Association (ASBS) changed its name to the American Society for Metabolic and Bariatric Surgery (ASMBS) to provide information on the beneficial effects of weight loss surgeries in the treatment of metabolic diseases, especially Type 2 Diabetes Mellitus (T2DM).

Today, the term metabolic surgery is used to describe weight loss treatments and procedures to treat metabolic diseases, particularly type 2 diabetes.

Gastric Bypass and Bilio-pancreatic diversion resulted in control / treatment of diabetes. This surgery can only be performed in obese patients with BMI> 35.

However, the need to control diabetes in non-obese patients has led to the development of Ileal Interposition surgery or Duodenojejunal bypass surgery for diabetics who do not require gastric bypass. This can be done by sleeve Gastrectomy in thin type 2 diabetics with a BMI as low as 30 or in overweight / obese diabetics.

Ileal interposition is a procedure in which part of the last part of the small intestine (ileum) is placed between 2 parts of the small intestine (jejunum) just beyond the stomach. No part of the small intestine is removed or bypassed. Duodenojejunal bypass is similar to gastric bypass, except that small intestine anastomosis is performed in the duodenum instead of the stomach. These two procedures provide patients with a good stomach volume to eat.

Only a few centers in the world carry out these procedures. More than 80% of normal weight patients with T2DM reached resolution of diabetes within 7 days to 3 months after surgery. Similarly, more than 85% of obese diabetics have the resolution of diabetes after surgery. The resolution of diabetes can vary with age, duration of diabetes, and insulin intake time.

Metabolic Syndrome

Metabolic syndrome is the name of a group of risk factors that increase the likelihood of developing heart disease, diabetes, and stroke.

To be diagnosed with metabolic syndrome, you must have at least three metabolic risk factors.

  • A wide waistline that shows abdominal obesity, or the "apple shape". Excess fat in the stomach area is a bigger risk factor for heart disease than excess fat in other parts of the body, such as the hips.
  • High triglyceride level (or if you are taking medication to treat high triglycerides). Triglycerides are a type of fat found in the blood.
  • Low HDL cholesterol level (or if you are taking medication to treat low HDL cholesterol). HDL is sometimes called "good" cholesterol. This is because it helps remove cholesterol from your arteries. Low HDL cholesterol levels increase your risk of heart disease.
  • High blood pressure (or if you are taking medication to treat high blood pressure). Blood pressure is the force that blood pushes against the walls of your arteries as your heart pumps blood. If this pressure rises and stays high over time, it can damage your heart and cause plaque buildup.
  • High fasting blood sugar (or if you are taking medication to treat high blood sugar). Mildly high blood sugar can be an early sign of diabetes.

Surgical treatment of Metabolic Syndrome is called "Metabolic Surgery".

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