New hope for diabetes treatment—surgery for diabetes.
Diabetes is an endocrine disease whose long-term chronic hyperglycemia can cause chronic complications such as retinopathy, diabetic nephropathy, peripheral neuropathy, peripheral vascular disease and cardiovascular and cerebrovascular disease, which has become one of the main causes of disability or death in China. In recent years, the number of people suffering from diabetes in China has increased rapidly, with the incidence rate reaching 9.7% and the total number of people nearly 100 million, making it one of the fastest growing regions in the world.
The traditional treatment of diabetes is oral hypoglycemic drugs or insulin injections, but the long-term dependence on drugs and the risk of drug resistance and complications are still relatively significant, and few patients are cured. In recent years, surgery has emerged as one of the more effective means of preventing and controlling diabetes.
In one of the world’s largest meta-analyses of surgical treatment of diabetes in the United States, the results of a study of 16,944 patients showed that 77% of patients experienced complete or partial remission of their diabetes after gastrointestinal surgery. For this reason the International Diabetes Federation (IDF) has issued a formal statement recognizing that weight loss surgery (i.e. diabetic gastric diversion surgery) can be one of the means of treating obese type 2 diabetes and recommending early interventional treatment.
In the academic exchange meeting of the Chinese Diabetes Federation, the pioneer of surgical treatment of diabetes, Francis K. Rubino of New York-Presbyterian Hospital, USA, pointed out that the treatment of diabetes can be done at an early stage. Professor Rubino pointed out that the main purpose of gastric diversion surgery for diabetes is to change the physiological flow of food, through gastric blockage, so that part of the food does not pass through the stomach but proceeds to the intestine, thus achieving the purpose of limiting food intake and reducing food absorption. After the surgery, the insulin resistance of the patient’s body is eliminated, and the change in the flow of food in turn promotes insulin secretion in the patient’s body, reduces apoptosis and proliferation of islet cells, and restores the function of the islet, thus enabling the majority of diabetic patients to be in remission, and for some diabetic patients, a cure can be achieved.
Currently, gastric diversion surgery is considered by the world of diabetes medicine to be the only way to achieve a clinical cure for type II diabetes. The American Diabetes Association has included gastric diversion surgery in the Diabetes Prevention and Control Guidelines; the 45th Annual Meeting of the European Diabetes Research Society in 2009 also confirmed that diabetes has become a surgically curable gastrointestinal disease. Gastric diversion surgery has been carried out in China since 2003, and 12,000 patients have already received the surgery.
Six advantages
Advantage 1: Cure diabetes, normal blood sugar, patients get rid of lifelong medication and do not need to control their diet. There are two main causes of diabetes: one is insulin resistance and the other is pancreatic islet failure. After gastric diversion surgery, insulin resistance is gone, islet function is restored, and diabetes is gone.
Advantage 2: Diabetic complications are recovered. While internal medicine cannot reverse the complications that have occurred in patients, after gastric diversion surgery, most patients gradually recover from diabetic complications such as hand and foot numbness, retinopathy, diabetic foot, abnormal urine protein, and hypertension.
Advantage 3: Avoid the occurrence of disability and death caused by diabetes. When diabetes develops to a serious degree, it can pose a serious threat to a person’s life safety. After gastric diversion surgery, blood sugar is normal, complications no longer appear, and the danger of diabetes is gone.
Advantage 4: Obese patients lose weight and thinner patients gain weight. Gastric diversion surgery can bring some unexpected effects to patients, very thin patients will gain weight after surgery, and very fat patients achieve satisfactory weight loss after surgery.
Advantage five, reduce the economic burden of patients. The relative cost is not high, which is the obvious advantage of gastric diversion surgery. According to the survey, most diabetic patients who have been ill for more than 5 years will have various complications, and the treatment of these complications is very expensive. For diabetic patients, a single surgical treatment with no further complications significantly reduces the economic burden in the long run.
Advantage 6: Gastric diversion surgery has low risk and fast postoperative recovery. The surgery can be done under laparoscopy, which is easy and fast, with little trauma and quick recovery. You can eat in 3 days after surgery and be discharged in a week. Post-operative diet and nutrition absorption are not affected.
Indications
1.Meets the diagnostic criteria of type 2 diabetes
2, Islet function is in compensatory phase (plasma insulin level > 1/3 of normal value)
3.Age ≤ 65 years old (appropriate relaxation for those in good health)
Contraindications
1, advanced diabetes mellitus, islet failure, autoimmune diabetes mellitus (LADA)
2.Serious organic diseases (coronary heart disease, cerebral infarction, renal failure, heart failure, severe hypertension, etc.) who cannot tolerate surgery
3, gastrointestinal tract dysfunction, moderate to severe diabetic gastroparesis
4, age > 65 years old