How bariatric surgery has gained prominence in the fight against diabesity

Gastric bypass surgery (GBS) is a bariatric procedure where we reduce the size of the stomach and also the length of the intestine of an obese patient. By reducing the volume of the stomach, the demand for food is reduced this eventually leads to weight loss

How bariatric surgery has gained prominence in the fight against diabesity
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Diabetes and obesity are two sides of the same coin, say doctors. This close association between obesity and diabetes led to the term ‘Diabesity’ coined by the World Health Organisation (WHO) to spread awareness on these two diseases.

According to medical experts, diabesity is the biggest burden on our health care system as obesity has emerged as a major cause of type 2 diabetes with over 80 per cent adult diabetics in India being overweight.

The latest figure released by the Ministry of Health and Family Welfare says more than a fifth of India’s population is suffering from diabetes.

While simple diet control and exercise is said to prevent incidences of diabetes, bariatric surgeries have emerged as a ray of hope for many who are struggling to lose weight along with controlling high blood sugar levels.

Dr Shashank Shah, organising chairman, IFSO APC OSSICON 2017 said a bariatric surgery such as gastric bypass, reduces the risk of developing type 2 diabetes by around 80 per cent in obese people.

“In 2009, we conducted a pilot study were around 15 Type 2 diabetes patients underwent the gastric bypass surgery and showed good results. They were no longer on medications and their blood sugar levels were in control. We then published the study in Surgery for Obesity and Related Diseases (SOARD) journal. It triggered a debate and everybody said that there is a need for more data. We then started working on it,” said Shah.

Shah later conducted a study with 80 people with type 2 diabetes who were on multiple medications or taking insulin. “Out of the 80, 40 underwent the surgery and 40 were put on medication. The study period was from 2010-15,” said Shah. He further explained that post-surgery, after two years, it was found that 30 per cent patients, who earlier took five to six tablets to control their blood sugar levels, were on a lighter dose of the medication.

“All the type 2 diabetes patients who underwent surgery are now maintaining normal blood sugar levels while the other 40 type 2 diabetes patients who were put on medications still have a problem in maintaining blood sugar level,” said Shah.

According to the International Federation for Surgery of Obesity & Metabolic Disorder, around 14,000 people undergo weight loss surgery in India every year. Explaining how the surgery works in getting diabetes under control, Dr Ajay Bhandarwar, head of the surgery department at Sir JJ Group of Hospitals, Mumbai said, “Gastric bypass surgery (GBS) is a bariatric procedure where we reduce the size of the stomach and also the length of the intestine of an obese patient. By reducing the volume of the stomach, the demand for food is reduced this eventually leads to weight loss.”

He said GBS, which is also known as metabolic surgery, can control Type 2 diabetes where the length of the small intestine is altered with or without altering the size of the stomach.

“When the small intestine’s length is reduced, a portion of the intestine that had never been exposed to raw food comes in contact with it. This leads to hormonal changes that have a beneficial effect on the functioning of the pancreas, which produce insulin, the crucial hormone for keeping a check on the sugar level,” said Bhandarwar.