What is metabolic syndrome?
Metabolic syndrome is a clustering of systemic disorders such as obesity led by the insulin resistance, diabetes mellitus, hyperlipidemia, hypertension and coronary artery disease.
How should metabolic syndrome be treated?
The purpose is to control the risk factors causing insulin resistance. If it is not achieved by the change of life style and medication, surgical therapy can be administered.
What is the role of the surgery in the treatment of diabetes?
When the blood glucose cannot be controlled by the standard treatment methods in type 2 diabetes patients, and organ damage due to high blood sugar occurs, if insulin reserves are sufficient, the surgical treatment can be administered.
Do all diabetes patients benefit from this surgery?
Information of all diabetes patients applying to our clinic is obtained in detail and then the patients are examined accordingly. Based on the results of these measurements, the surgery is administered to the patients with sufficient insulin reserves and who can benefit from the surgery.
If the blood glucose cannot be controlled in type 2 diabetes patients, it causes irreversible damages such as renal failure, vision impairment, nerve damage (impaired sensing, wounds in the sole) treatments of which are difficult and long. Diabetes surgery is administered when the blood glucose cannot be controlled with medication, diet and exercise in the treatment of diabetes mellitus.
Stimulus is sent to the pancreas for secreting the insulin when the food reaches to the end of the small intestine (ileum). Blood glucose level is regulated by means of the hormones secreted. Moreover, fullness occurs owing to the agents secreted by the ileum. These surgeries aim at balancing the blood glucose prior to rising by making ileum find the food earlier. Both surgeries are initiated with the sleeve gastrectomy. Accordingly, nutrient intake is reduced, stomach expansion is prevented and level of ghrelin hormone in the body is reduced.
Generally bypass methods as mainly mini gastric bypass are employed in the diabetes surgery. Insulin reserves of the patient should be sufficient for a successful outcome. In other words, pancreas should secrete insulin sufficiently. Insulin reserve of the pancreas is measured by the pre-op investigations. If it is sufficient, the patient is included in the operation program.
Who is eligible?
- BMI 40 and >40 class 3 obesity patients
- BMI 35-40 class 2 obesity patients: if the blood glucose cannot be controlled in spite of change of life style and optimal medical therapy
- BMI 30-35 class 1 obesity patients: if the blood glucose cannot be controlled in spite of medication including insulin, metabolic surgery should be considered.
Who is not eligible?
- T1 diabetes patients
- Drug or alcohol addiction
- Uncontrolled psychiatric disorder
- The patient is under the age of 18.