Diabetes & Obesity
The prevalence of diabetes is an epidemic, with more than 170 million people affected worldwide in 2000. It is estimated that this number will exceed 366 million by 2030.
In the year 2000, for the first time in the history of human evolution, the number of adults with excess weight surpassed the number of those who were underweight. Excess body weight is now widely recognized as one of leading health threats in most countries around the world and a major risk factor for diabetes mellitus, cardiovascular disease & hypertension.
There are two types of diabetic patients
1. Diabetes with morbid obesity
There has been a strong interest in weight loss surgery (bariatric surgery) as a treatment for diabetes in obese patients. There is strong evidence that bariatric surgery helps in the cure/ remission of diabetes and the need for anti-diabetic medication.
Remission from diabetes can vary between 60-95%, depending on type of procedure done, such as, Gastric bypass and Gastric sleeve procedure. Apart from weight loss and improvement in diabetec status, these surgeries help in improving blood pressure.
1% reduction in the body’s weight is associated with approximately 1mm in systolic BP and 2mmHg in diastolic BP. Whereas, 10% weight reduction leads to 20% less risk cardiovascular disease.
2. Diabetes without morbid obesity
This category of diabetic patients are overweight, with a BMI of 30–35. They can benefit from other procedures such as:
- Ileal transposition
- Endobarrier: an endoscopic procedure giving good results in diabetic patients
In conclusion, we can say that
- Diabetes can be cured/ improved with surgery, especially in obese patients
- Surgery should be offered as solution during the early stages for eligible patients
- Weight loss surgery helps in weight loss, benefits diabetes and reduces cardiovascular risk in morbidly obese patients.
- Non obese patients can consider newer procedures, such as: ileal tranposition &endobarrier procedure that are showing encouraging results.
Dr. Girish Juneja MS , MBBS
Dr. Girish is a well-experienced laparoscopic surgeon with more than 25 years of experience to his credit. He had his basic and advanced laparoscopic training from Ninewella Medical College, UK and did his diploma in minimal access surgery from France. He has served as Head of Surgery Department in various reputed hospitals since 1990 and currently he is the Head of the Weight Loss and Metabolic Surgery Center at Al Zahra Hospital Dubai.