With the reaffirmation of the Chinese Diabetes Prevention and Control Guidelines (2017 edition) for metabolic surgery for the effective treatment of type 2 diabetes, weight reduction metabolic surgery has become a more preferable treatment for diabetes than traditional internal medicine. So is every diabetic patient treatable with gastric bypass surgery?
The treatment of diabetes has not received the attention it deserves in China, and there are far more undiagnosed diabetics than diagnosed ones. The effectiveness of internal medicine in treating type 2 diabetes is extremely poor, and the highest sample survey proved that only 27-35% of diabetic patients are able to control their sugar to meet the standard, and most of them are progressively aggravated.
Diabetes is difficult to control blood sugar and brings great inconvenience to life, such as playing insulin, saving and carrying insulin in the heat, and strict diet control, etc. In the words of our patients: there is no quality of life with diabetes, and it feels like death is approaching step by step, especially nowadays, the age of diabetic patients is moving forward, and more and more young diabetic patients are becoming the main force.
The basic situation of diabetic patients in China is different from that of Westerners, mainly in that Chinese diabetic patients are not as obese as Western patients, Chinese diabetic control is worse, Chinese patients are less compliant, Chinese diabetic patients have more abdominal obesity and more serious complications, so they cannot follow the Western indications for surgery.
So, which Chinese diabetic patients are suitable for surgical treatment? Physicians and surgeons in mainland China as well as in Taiwan and other Asian countries have conducted relentless exploration and research, which is now combined with the release of China’s 2014 guidelines for the surgical treatment of obesity and diabetes and summarized in the literature as follows: For Chinese diabetic patients, if your weight meets the criteria for obesity (BMI = weight kg / height m squared) > 30 and you have poor glycemic control, it is recommended Surgery, 85% of patients will recover completely, get rid of glucose-lowering drugs, and will improve blood lipids, blood pressure and other complications.
If your BMI is >25 and your islet function is good and your blood sugar is not well controlled, then surgery is also recommended. Of course your doctor will evaluate your islet cell function before surgery, and for those patients with a BMI of 35 or more it is even more strongly recommended that you receive surgery immediately.
The Chinese Guidelines for the Surgical Treatment of Obesity and Diabetes (2014) stipulate that diabetic patients who meet the following conditions can undergo diabetic surgery: Type 2 diabetes mellitus duration ≤ 15 years, and the pancreatic islets still have some insulin secretory function, fasting serum C-peptide ≥ 1/2 of the lower limit of normal. BM (body mass index) ≥ 27.5 If the waist circumference is ≥90 cm in men and ≥85 cm in women, the recommended age for surgery is 16-65 years.