New Delhi, Dec 10 While uncontrolled diabetes is unfolding as a silent crisis in India, resulting in organ damage and failure, metabolic surgery can help prevent it, according to a doctor at the All India Institute of Medical Sciences (AIIMS) Delhi on Wednesday.
India is already known as the diabetes capital of the world, but Dr. Manjunath Maruti Pol, Additional Professor, Department of Surgery at AIIMS, New Delhi, shared that uncontrolled diabetes is surging complications such as kidney failure, heart attacks, strokes, neuropathy, and retinopathy, among others.
In India, 70 million people suffer from diabetes, and 50 per cent of them have uncontrolled diabetes, shared the doctor, noting that the worldwide criteria for HbA1c (a measure of blood sugar control) is 7. But in India, it is 7.5.
"Uncontrolled diabetes can be defined as when HbA1C levels continue to remain at 7.5 despite taking 3 or more than 3 medicines and controlling diet and lifestyle for at least 2 years," Pol said.
He stated that HbA1c is inversely related to the occurrence of complications. In other words, if HbA1c increases, organs will begin to fail in a short duration, leading to death.
"Surgery is now an internationally recommended treatment for selective uncontrolled Type-2 Diabetes Mellitus (T2DM)," the expert said. Surgery as a treatment for diabetes was formally recognised in 2016 by the International Diabetes Federation (IDF).
How it is done
According to the guidelines, this surgery can be performed on patients aged 18 to 65 years.
Unlike Type-1 diabetes, where surgery is conducted on the pancreas, the surgery for uncontrolled Type 2 diabetes is done on the stomach and intestine.
"The stomach is made small and small intestine is joined, with this, the stomach is sized like a tube, the size of that stomach varies depending on the metabolic profile of the patient, and small intestine, we join that small tube, so that the food goes directly to the intestine, bypassing the duodenum,” Pol said.
So when the food goes directly there, there are certain GLP or hormone release, in a physiological dose and rhythm, time, quantity, he added, noting that the surgery halts the damage.
"In our own retrospective analysis, we have performed over 100 surgeries, with 35 per cent on patients with uncontrolled Type-2 diabetes. All of them are currently off diabetes medications,” the expert stated.
He lauded the rapid pace of improvement post-surgery. Many patients show near-normal blood sugar levels from the first post-operative day, proving that the benefits are weight-independent.
“The cost of the surgery, done via laparoscopy or robotic, is between Rs 3 and 6 lakhs,” Pol said, adding that the benefits are indeed significant.
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