Weight-loss surgery, a cure for diabetes

New Delhi: Could weight-loss surgery be a cure for type 2 diabetes? That's exactly what this report suggests.

Dr. Atul Peters, director and head, metabolic and bariatric surgery at Fortis Hospital said, "Obesity is a major risk factor for diabetes. It makes cells less able to use insulin to bring sugar in from the bloodstream. When you are already insulin resistant (diabetic or pre-diabetic), then it can be even harder to lose weight."

Peters noted that weight-loss surgery is dramatically more effective in the treatment of type 2 diabetes than a conventional treatment of diet changes and medication.

Patients with conventional treatment of medication, along with rigorous monitoring of patient's diet and lifestyle do not show progress, but patients, who went under the knife, saw dramatic improvement. 85 percent of patients, who underwent gastric bypass surgery, went into remission and got rid of diabetes.

A 46-year-old home maker, Anshu Jain, from Delhi was diabetic and suffered with hypertension, dyslipidaemia, sleep apnoea, snoring, stress incontinence, lower limb insufficiency and sarcoidosis. She weighed 127.5 kg (BMI 46) when she underwent metabolic and bariatric surgery in November 2012. In only 18 months, she lost 39.5 kg, her body weight dropped to 88 kg and BMI came down to 30.7. Her diabetes got resolved, HbA1c dropped from 7.8 to 5.3 along with resolution of all other comorbidities all this while.

Harish Kumar Mangwani, a 62-year-old morbid obese businessman from Delhi, was fighting everyday with obesity and endless number of co-morbidities, like diabetes, hypertension, sleep apnoea, snoring, asthma, joint pains and backache. He was on oral medicine as well as was taking insulin for diabetes and other medications for rest of the diseases. His weight was 127.3 kg, which had made his life miserable. But after undergoing the surgery, he was fine.

According to Metabolic Surgery Foundation of India, the number of bariatric surgeries in India has seen an upward graph for cure of Diabetes, from about 3500 in 2011 to over 10,000 in 2013. At present, approximately 12000 bariatric surgical procedures are being performed every year in India.

After surgery, post-operative care is an essential part of the treatment. To achieve optimum results from the surgery, patients should strictly follow the diet rules for at least a month. In first month, patient is advised to be on a full liquid diet for first 15 days, followed by light food diet for next 15 days and gradually he can get back to a normal diet. One should stop eating on full.

Because after surgery it is critical that one does not eat to the point of feeling overfull. This could lead to stretching of pouch. One should do at least 30 minutes of physical activity every day.

Peters continued, "National Institute of Health guidelines restricts patients with BMI greater than 40 kg/m² or greater than 35 kg/m² with co morbidities such as diabetes to undergo surgeries. Therefore, we recommend NIH to review the guidelines beyond BMI and set new standards for such surgeries."