Surgery for Diatebes

Who is a candidate for metabolic surgery?

Since metabolic surgery is a fairly new surgical subspecialty, there is little evidence in the literature to guide surgeons as to which patient will actually get cured from diabetes following metabolic surgery.

Most experts agree that candidates with greater chance of getting cured following metabolic surgery are the following:

  • Patients with type 2 diabetes
  • Diabetes diagnosed within the last 10 years
  • Diabetes treated with insulin injections for no more than 7 years
  • Patients without diabetes-related complications (i.e., chronic renal failure)

However, there is little evidence about what happens to patients without these characteristics that undergo metabolic surgery. For an objective evaluation of the function of the pancreas, patients are required to take a 3-hour glucose tolerance test and insulin curve. This test consists of testing fasting blood glucose and insulin levels.

You take a standard glucose load and blood glucose and insulin levels are tested every hour for three hours. This test provides information about how well your pancreas responds to increases of blood glucose levels by concomitantly increasing blood insulin levels.

It is essential for your pancreas to produce insulin in order to respond well to metabolic surgery. If your pancreas does not produce insulin, chances are that you are not get cured with metabolic surgery. Nonetheless, many patients that do not produce insulin have responded partially to metabolic surgery. This means that their diabetes improves.

Following metabolic surgery, diabetes is better controlled and blood glucose levels are kept within normal range with conventional medical therapy.

Normal digestion of carbohydrates

Normal digestion of food begins in the stomach. Gastric acid dissolves food into microscopic particles that can be absorbed through the intestine (proteins, fat, carbohydrates, etc). Carbohydrates are finally converted into glucose (blood sugar).

Most of the glucose is absorbed in the duodenum (the first portion of the small intestine). Once in the blood, sugar needs insulin to get into the cells to be used as an energy source.