Is there a Surgery for Diabetes & Metabolic Syndrome?

 Doctor: How long has it been to your Bariatric Surgery?

Patient: My surgery was done in August 2021.

Doctor: So, one year is not completed yet.

Patient:Yes! I have completed 9-10 months after surgery.

Doctor: It has been 10 months to your surgery.

What problems did you have before surgery?

Patient:My weight was 105 Kg, but the major problem I had was Diabetes.

Doctor: Ok.

Patient:My Liver was compromised too.

The major issue was Diabetes, my Fasting blood sugar levels used to be around 450-500 mg/dL.

Doctor: Fasting?

Patient:Yes!

My random blood sugar levels were way higher. and that was affecting my eyesight.

Doctor: Ok.

Patient:Yes!

Eye number was changing very frequently.

Doctor: Ok.

Doctor: Did you get your fundus examination done before surgery?

Patient:Yes! he said it was because of Diabetes.

Doctor: Ok.

Patient:Yes! that problem was because of Diabetes.

Doctor: Instead of these problems, before surgery, your triglycerides were on the higher side?

Patient:Yes!

Doctor: Triglycerides were 4-5 times higher than the normal range.

Patient:Yes!

Doctor: Do you know what was the problem with your liver?

Patient:All, I knew that my Liver was 60% damaged.

Doctor: This problem is called NASH.

Did you drink alcohol before surgery?

Patient:Yes!

Doctor: Those who do not drink alcohol, their liver is damaged because of fat, which is called fatty liver.

The next step of Fatty Liver is NASH (Non-alcoholic steatohepatitis).

It means these days Liver damage is caused without alcohol intake.

Patient:Yes!

Doctor: The main reason for Liver transplants these days is Fat and alcohol is the second reason for this.

Patient:OK.

Doctor: Fat was blocking your liver.

This fat was affecting function of liver.

Patient:There were many other issues related to this Fatty liver like I had weakness and low energy levels before surgery. I wasn't able to do any work.

Doctor: Ok.

Patient:This was affecting me both physically and mentally. 

Doctor: This is a vicious cycle.

Your weight was 105 Kg, which was not too much.

Patient:Yes!

Doctor: If a person is overweight and has health issues like uncontrolled Diabetes and compromised Liver and increased triglycerides, this all is like a punishment for him.

Patient:Yes!

Doctor: This is called Metabolic Syndrome.

It is easy to blame anyone for being obese, but the main reason for obesity is that our body absorbs everything.

Our system is old which was designed for the times when we used to run for hours in the search of food.

Now, our lifestyle is sedentary.

Many patients have long intestines which absorb more. Actually, Metabolism is not in our control.

In this surgery, we have customized design according to the patient so that patient will absorb less. We have decreased the size of the stomach and bypassed some part of the intestine.

In your case, we wanted 30-35 Kg weight loss.

How much is your weight now?

Patient:My weight is approx. 70 Kg.

Doctor: Ok.

How are your blood sugar levels now?

Patient:After surgery, I checked my Blood sugar levels, it was all normal. Now I don't even check it.

I don't feel any problem.

Doctor: Do you eat sweet things?

Patient:Yes!

Doctor: After eating sweet things, blood sugar levels stay normal.

Patient:Yes!

Doctor: But don't take it for granted.

Patient:No.

Doctor: Many patients think that their Diabetes is cured with surgery, which is not right. you are potentially Diabetic now.

Patient:Ok.

Doctor: Check your Blood sugar levels when you feel sick, or you have a fever, it may be on the higher side in that days.

Or it is possible if you gain weight in the long run, like in the next ten years.

Patient:Ok.

Doctor: To maintain your weight eat less carbs, and more fruits or vegetables.

You can eat any seasonal fruit.

But don't drink juices as it contains more sugars.

Ok.

Doctor: Eat more salads.

You will be able to eat more in the long run.

Patient:If Diabetes reoccurs, then it will take time to reach up to that point, at which it was before surgery.

Doctor: Exactly, it is a controversial science. Earlier no one used to believe this.

Many people used to say that this surgery is good for Obesity, not for Diabetes.

But I have done many debates on this topic at the international level.

Patient:Ok.

Doctor: Now, an association of Endocrinologists in America has also approved that this surgery should be done in Diabetic patients.

Because there are many problems people are suffering these days.

Patient:Yes!

Doctor: With a small change in design (Bariatric Surgery) , we are able to decrease the absorption and control blood sugar levels.

Blood sugar levels are under control now, because food is touching directly on a new point in the intestine.

Patient:Ok.

Doctor: Now, after eating something sweet, your blood sugar levels will decrease.

Patient:Yes!

Doctor: Because Pancreas is receiving stronger signals now.

It is like a new sensor now, which is working as an automated Insulin pump.

But it can also be desensitized.

If your Diabetes reoccurs after 10 years, then it will take more than 10 years to reach that point.

This was the topic of debate. we can do a customized surgery on Diabetic patients.

We have customized the surgery in your case.

The hidden benefit of this surgery in your case is that Your value of Liver Fibro scan was about 20Kpa at the time of surgery and this is 4.4 Kpa now.

You were going towards Liver transplant.

Patient:Yes!

Doctor: Now, you are better.

The difference is that you lost a lot of fat that was deposited in your body.

Your Insulin resistance and metabolism are better now.

Patient:Ok.

Doctor: We should make patients aware of Metabolic Surgery and we should not be afraid of this surgery.

Patient:I am not taking any medicine for Fatty liver now.

Doctor: Ok, your gastroenterologist has stopped your medication now.

Patient:He said everything is ok now.

Doctor: Everything is normal now.

Patient:Yes!

Doctor: Keep your weight under control and avoid sugars.

Patient:Ok.

Doctor: Start doing some exercise, take multivitamins regularly.

Get your blood tests done once in six months.

Patient:Ok.