Does gastric diversion lower blood sugar? How does surgery for diabetes work? In a situation where diabetes has always been treated with internal medicine, the sudden appearance of a surgery that can cure diabetes would make any normal person doubt its authenticity and effectiveness. There is also a risk of accepting it without knowing anything about it. However, when people know more about this procedure, they will not be skeptical anymore. First of all, it is necessary to talk about the principle of this procedure. This surgery is to surgically alter the flow of food through the gastrointestinal tract, so that high concentrations of nutrients enter the distal part of the intestine earlier, stimulating the secretion of various functional cells (such as L-cells) in the distal part of the intestine, increasing insulin sensitivity and reducing insulin resistance; the surgery also alters the secretion and expression of various gastrointestinal hormones (such as GLP-1, a hormone that is extremely important for the body to fight diabetes), promoting the proliferation of pancreatic β-cells and reducing insulin resistance. The surgery also changes the secretion and expression of various gastrointestinal hormones (such as GLP-1, a hormone extremely important for the body to fight against diabetes), promotes the proliferation of pancreatic β-cells and improves the function of the islets, thus providing a good remission of diabetes. Then, there is the question of the indications for the surgery, because the effectiveness of the surgery is also based on the indications. This surgery was first introduced from abroad, and the surgical standards were developed according to the standards of foreigners, so copying all of them will definitely lead to “unconventional” situations. Since the first surgery in 2008, I have been dedicated to the improvement of the surgery and made some modifications and corrections to the indications for the surgery according to the physique of our population, as follows: 1) meeting the diagnostic criteria for type 2 diabetes; 2) islet function in the compensatory phase (plasma insulin level > normal); 3) history of diabetes not exceeding 15 years, with some residual function of the islets, but more than The function of the islets is poor for more than 15 years, and the surgical effect is poor at this time, and often the insulin cannot be completely stopped after surgery. 4. 6, type 2 diabetes with high obesity, BMI>=35kg/m2, surgery is preferred; BMI>=28kg/m2, unsatisfactory drug treatment can choose surgery. However, surgery should not be the last treatment choice for diabetic patients, but should be considered as one of the treatment choices in the earlier stages of obese diabetes treatment. Thirdly, it is the effectiveness and safety of the surgery. As mentioned above, this surgery can only be done if the conditions are met. Why? Because patients who do not meet the requirements are not physically able to accept the changes brought about by the surgery, and especially in the case of thin diabetic patients, there is a high risk of malnutrition, which reduces the effectiveness and safety of the procedure. There is also an increased chance of risk in some older patients. However, one thing must be clear, as long as the conditions for the procedure are met and there are strict management mechanisms for each patient before, during and after the procedure, this procedure is effective and significantly better than conventional medical treatment methods.