Type 2 Diabetes Surgery
Treatment of Type 2 Diabetes
Treatment of Diabetes The goal of diabetes treatment is to reduce blood glucose to normal levels and to control micro and macrovascular complications and cardiovascular risk factors. In addition to providing weight control, other known risk factors such as blood pressure and lipid levels should also be controlled.
Lifestyle Change
Invariable elements of treatment in all types of diabetes are patient education, medical nutrition therapy and exercise. These treatments should be started from the moment of diagnosis in individuals at risk and high risk for diabetes, and medical nutrition therapy should be questioned at each evaluation. The aims of medical nutrition therapy are to provide metabolic control, to prevent chronic complications of diabetes or to reduce the rate of development of complications, to determine the nutritional needs of the individual by taking into account the personal and cultural characteristics of the individual, and to gain self-management skills in different situations that may be encountered in daily life (exercise, hypoglycemia, acute illness, etc.).
With medical nutrition therapy, HbA1c levels can be reduced by about 1% in type 1 diabetes and 1-2% in type 2 diabetes. With medical nutrition therapy, an improvement is observed in diseases that accompany diabetes such as dyslipidemia and hypertension. Regular physical activity planned by adapting to existing complications should be recommended to all individuals with diabetes. Regular physical activity reduces the resistance of a hormone that regulates sugar metabolism secreted from the pancreas in people with prediabetes and contributes to the prevention of type 2 diabetes development.
It facilitates the regulation of blood glucose values, lipid levels and blood pressure control in individuals with diabetes. Although the goal of the exercise program differs according to the patient, in order to benefit, it should be continued for 20-3O minutes at least 3 times a week and the appropriate submaximal heart rate for the patient should be reached.
METABOLIC SURGICAL OPERATIONS
Transit Bipartition Operation
With Transit Bipartition surgery, you can get rid of Type-2 diabetes and start a new life. With Transit Bipartition surgery, you can get rid of Type-2 diabetes and start a new life.
By increasing insulin sensitivity, it treats Type-2 diabetes patients with very high success. With Transit Bipartition surgery, you can also get rid of high cholesterol, high blood pressure and excess weight. You will regain your health in a short time and resume your normal life. The most important feature of this surgery is that it treats Type-2 diabetes hormonally, avoiding mechanical restriction and malabsorption.
Which diabetics are eligible for Transit Bipartition?
We operate on Type-2 diabetics. First, insulin production of the pancreas should be evaluated with specific blood tests. According to the results of this test, we perform the surgery on Type-2 diabetics who have sufficient insulin reserves in the pancreas. To the extent that the remaining reserve is large, post-operative success can increase up to 100%. These tests are therefore very important when selecting patients.
Advantages of Transit Bipartition:
This surgery with many advantages is highly preferred and recommended both in Turkiye and around the world today. These advantages include:
- The integrity of the stomach and duodenum is preserved.
- The entire small intestine continues to absorb and process food, so there is little or no need for vitamins. This is the most important advantage.
- Allows all kinds of endoscopic procedures.
- The surgery is easily reversible in any case.
- It shows strong neurohormonal activity. The risk is very low while the safety is very high. The patient returns to normal life in a short time.
Ileal interpositions
The surgery has two different versions. In both techniques, the gastric sleeve procedure is a standard. In relatively underweight patients, only the fundus is removed to reduce ghrelin hormone activity.
For patient selection, insulin production by the pancreas is crucial. The operation is performed for patients who, according to specific blood analyzes, still have sufficient insulin secretion in the pancreas. Type-2 diabetics under 18 and over 65 are not eligible.
Non-diverted (jejuno-ileal interposition) technique
A 200 cm segment is prepared from the end of the small intestine, preserving the last 30 cm of the small intestine, and “interposed” into the initial section of the small intestine. Insulin-sensitizing hormones are activated. The activity of the hormone ghrelin in the stomach is reduced. An earlier feeling of satiety is achieved. In this surgical technique, in which there are no absorption problems, the food is also absorbed by the duodenum. It is more preferred for low-weight Type-2 diabetes patients.
Diverted (duodeno-ileal interposition) technique
In addition to the gastric sleeve operation, the connection between the stomach and duodenum is closed in the second part of the duodenum. A 170 cm segment is prepared from the end of the small intestine, preserving the last 30 cm of the small intestine, and anastomosed to the first part of the duodenum.
The other end is anastomosed to the initial part of the small intestine and the end of the small intestine is “interposed” between the stomach and the initial part of the small intestine. Since the duodenum and the initial part of the small intestine are bypassed, there is also a partial bypass.