Treatment of Diabetes in India
Diabetes is now 100 % curable
Are largely 2 Types of Diabetes and both are curable.
Diabetes an endemic
The whole world is struggling the disease called Diabetes. Not only that it takes life away from us, it also is a carrier disease for even more deadly disease such as Cardiac Ailments (Heart Attacks), Renal Ailments (Kidney Failures), Ophthalmological Ailments (Glaucoma and Retinopathy), Hyper –Tension, Strokes, Diabetes foot and Vascular ailments resulting into Limb amputations.
All these years we have been fighting to manage diabetes with controlling diets, exercising, taking oral pills and getting insulin injections. Though we have been able to check the extent of disease to a certain limits but we have not been able to treat it. Neither have we been able to keep at bay the diseases associated with diabetes.
What is Diabetes?
Diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced.
There are largely 2 types of Diabetes–
- Type 1 results from the body’s failure to produce insulin, while
- Type 2 results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency. Acute & serious long-term complications include cardiovascular disease, chronic renal failure, and diabetic retinopathy (retinal damage).
COMPLICATIONS
- Macro-vascular complications occur due to accumulation of fat within the walls of the blood vessels (atherosclerosis).
- Coronary artery disease (Ischaemic heart disease), peripheral vascular disease (reduced or loss of blood supply to the legs resulting in non healing ulcers, gangrene of toes or limbs), stroke (reduced blood supply to brain causing damage), erectile dysfunction.
- Diabetic retinopathy (damage to the retina in eye and blindness), diabetic nephropathy (damage to the kidney, loss of protein in the urine, renal failure) are some examples
The cure
Now the Surgeons have found out a cure for diabetes. It has been found that certain hormones which are responsible for Blood Sugar levels can be manipulated with the help of surgery. Thus, if we do a metabolic surgery of stomach and rearrange small bowel. This leads to changes in several gut hormones that control release of insulin and its action. It cures as a result of several factors, some of them are increased incretins, reduced anti-incretins, reduced ghrelin, increased action of leptin, rapid emptying of stomach, calorie restriction and weight loss. Sleeve Gastrectomy -One of the surgeries that can be performed to achieve this is called Sleeve Gastretomy. Sleeve Gastrectomy is a metabolic surgery that results in calorie restriction and weight loss.Weight loss has positive impact on maintaining normal glucose levels in blood.
Weight loss increases insulin action, reduces damage to beta cells in pancreas. If surgery is performed on normal weight diabetic patients, weight loss is not much or will not be there. Thus these patients become free of diabetes. In Sleeve Gastrectomy, up to 80 percent of left side of the stomach is removed and the first part of the duodenum is disconnected using linear cutter stapler. A significant segment of the ileum is isolated by dividing the ileum proximal to the Junction of the small and large bowels. Bowel continuity is restored by joining the remaining ends of the ileum and all the mesenteric gaps are closed. In this operation Ghrelin hormone – the hormone responsible for hunger production is reduced, as fundus of the stomach is removed. Sleeve Gastrectomy involves a surgery wherein we remove part of stomach procedure and rearrange small bowel. This leads to changes in several gut hormones that control release of insulin and its action. Sleeve Gastrectomy component of metabolic surgery results in calorie restriction and weight loss. Weight loss has positive impact on maintaining normal glucose levels in blood. Weight loss increases insulin action, reduces damage to beta cells in pancreas. The process impacts the blood sugar levels and thus resulting into freedom from Diabetes.
Diagrammatic Explanation of LAPAROSCOPIC SLEEVE GASTRECTOMY WITH DUODENOILEAL INTERPOSITION (SG – DII) To Treat Diabetes
It is a most effective metabolicsurgery. In this type of surgery, up to 80 percent of left side of the stomach is removed and the first part of the duodenum is disconnected using linear cutter stapler. A significant segment of the ileum is isolated by dividing the ileum proximal to the Junction of the small and large bowels. Bowel continuity is restored by joining the remaining ends of the ileum and all the mesenteric gaps are closed. In this operation Ghrelin hormone – the hormone responsible for hunger production is reduced, as fundus of the stomach is removed.
LAPAROSCOPIC SLEEVE GASTRECTOMY WITH DUODENOJEJUNAL BYPASS (SG – DJB):
It is actually a combination of Sleeve Gastrectomy with roux – en – y gastric bypass.
In this type of surgery, up to 80 percent of left side of the stomach is removed and the first part of the duodenum is disconnected using linear cutter stapler. Jejunum is divided distal to duodenojejunal flexure and Bowel continuity is restored and all the mesenteric gaps are closed.
To become eligible for this patient. The person needs to be suffering from type 2 diabetes who is fit, aged between 18 to 65 years, duration of diabetes should be > 3 years and < 20 years.
The Results
As a result of this surgery In obese people, because of narrow stomach tube, food intake is restricted, which leads to calorierestriction and weight loss. All these factors contribute to the resolution of diabetes in more than95 percent of type 2 diabetic patients.
In more than 65% patients HbA1C becomes < 6% and in 30% of patients HbA1C level between6 and 7 % is achieved. Patients are off insulin and tablets. More importantly it is almost a certainty that You are Diabetes Free !!!
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