- Despite medical treatment, diabetes will steadily continue to progress.
- The complications of diabetes are many: it causes irrecoverable damage to organs like the kidneys, nerves, heart and brain, and even organ loss may be experienced.
- The operation will take high sugar levels under control right away. It will reduce the load on the kidneys and the liver. After the operation, high cholesterol, high triglyceride and problems related to these will also be eliminated. Beside this, you will be relieved of obesity and be able to control your weight.
Why is the operation applied to type 2 only?
Type 2 diabetes patients have sufficient insulin levels, secreted by the pancreas beta cells. But this insulin is not used at the cellular level. That you have insulin deposits and activity above a definined level are the most important factors for the success of this surgery. Since type 1 diabetes patient don t have sufficient insulin, they will not benefit from Metabolic Surgery applications.
Which type of diabetes do I have? Type 1 or Type 2?
Diabetes during childhood is type 1. A majority of diabetes in juveniles is also type 1. Some analysis and measurements are necessary for the typing of diabetes developed by adults.
Am I an appropriate candidate for the operation?
There are some criteria in order to decide on an operation. You may be an appropriate candidate for the operation:
- If you have a diabetes background of at least 2 years and your sugar cannot be taken under control through the appropriate medical or insulin treatments,
- If your disease steadily progresses and organ damage has begun.
Is the success rate exactly determinable prior to the operation?
Yes! Using pre-operative test results, it is determinable to what degree the patient will benefit from this procedure.
Who should hurry for the treatment?
- Those whose sugar could not be regulated though all tried treatments,
- Those with a typically high blood sugar level (HbA1c),
- Those with progess of the disease and in which the desired result could not be achieved by medical/insulin treatment
- Those with possible complications in kidneys, eyes, liver, feet, heart and other organs should not wait longer.
Who doesn’t need an operation?
Patients with a stable sugar level for years, or who are able to control this easily or with a condition that is not progressing and without any weight problem.
What are the criterions?
You need to comply with the 4 criteria below in order to benefit from Metabolic Surgery applications, it is necessary:
- That you have an insulin supply of at least 20%, preferably 25%, and that at least half of this supply is active,
- That your fatty tissue sourced resistance hormones are within defined limits,
- That some materials spread by the leucocytes and released into the blood, causing damage to the insulin producing beta cells of the pancreas, are negative or within normal limits.
Will I definitely benefit from the Metabolic Surgery operation?
If your test results should be positive, you will benefit from this application.
Will I be completely relieved of sugar problems?
Whilst the complete remission (recovery of normal) after the operation varies according to the operation itself, remission rates between 8 to 30 years is in the order of 70%-98%. This depends on the insulin deposits in your body, their activity and other results. The success rate of Metabolic Surgery applications is not 100%. But, it should be appreciated that the range of 70-98% is a high success chance. On the other side, the benefit ratio from the operation (decrease in the number of medicines, relief from insulin or decrease of its dosage) is without doubt 100%.
Is this a pancreas operation?
No. The performed processes are basicly a displacement process performed in the small intestine. In addition to this, in situations where it is deemed necessary deemed (depending on the disease level, the hormone levels in the blood and the activity of these hormones), required surgical operations regarding the stomach volume, stomach form and the fatty tissues wrapping the organs in the abdomen are performed.
How does the operation work?
The insulin in the body of type 2 diabetes patients will not fulfil its function at the cellular level during the pre-operational period. Either the insulin cannot enter into the cell or if it ever should, it cannot fulfil its functions inside. This is called insulin resistance. After the operation, digestive system hormones, causing insulin resistance, will weaken. Serious changes occur to digestive system hormones called incretin and ghrelin. As a result, the insulin resistance cycle is broken. The insulin remains free and insulin sensitivity at cell level increases. This means that your sugar will be regulated since your hormones have been changed.
Is Metabolic Surgery an obesity operation?
No. It is among those operations able to be applied to type 2 diabetes patients. The operation applied to lightweight diabetes patients differs from the operation to be applied to obese diabetes patients.
Since when have these operations performed?
The beginning of Metabolic Surgery goes back to the 1950′s. The Biliopancreatic Diversion (BPD) operation, successfully applied until the present and constituting one of the fundaments of Metabolic Surgery, has been done in Italy since 1974 by Prof. Dr. Nicola Scopinaro, who also educated Ass. Prof. Dr. Alper Celik. Bastric By-Pass operations have been applied since the 1990′s and sleeve gastrectomy and the ileal interposition operations have been undertaken since the early 2000′s.
Is it a safe operation?
It is safe. The incision and re-union processes during the operation are performed with single-use apparatus. All tools and devices used are products of the latest technology; the surgical team and the aenesthesia specialists who will attend your operation are highly experienced and Metabolic Surgery committed physicians who have perform these operations for a long time already.
Are there any complications?
Every operation bears a risk. And these operations bear risks as much as any digestive system operation. The total complication rate is at about 10%. Bleeding, infection, leakage, abscess development and narcosis related problems can be mentioned among these.
How long does the operation take?
Whilst this varies depending on the condition of the patient, this can change between 1.5 to 7 hours.
How long does a recovery take?
The operations are frequently applied using the laparoscopy method, via small openings in your belly aided of cameras. Generally, patients can stand the following day. It is necessary to stay in the hospital 5-6 days. To be able to start working will take 10 to 15 days.
When can I eat meals?
You may drink water during the first day afer the operation. The intake of other liquids except water begins 2 days later. And the intake of semi-solid and solid food starts between the 8th to the 30th day, varying according to the operation itself.
When can I return to work?
You can return to work 2 weeks after operation.
How long will I be hospitalized?
You will need to stay totally 6-7 days at the hospital. Your hospitalization will begin 1-2 days before the operation and you hould stay a further 4-5 days after the operation.
When do I need to come again to the hospital after the operation?
You will need to come to the hospital for blood tests in the 1st, 3rd and 6th month after the operation. Thus the development in your body will be observed. Then it will be necessary to take you into the annual tracking program. Afterwards we request you to attend to the monthly organized Group support meetings and to share your opinions about the operation with the physicians, other ex-patients and patients planning to be operated on.
What are the other advantages of the operation?
Body weight reaches normal levels in patients with weight problems. Hyper-tension problems are eliminated, thus, anti-hypertensive medicaments will no longer be needed. Significant recovery occurs in the damage to organs like kidneys, eyes, liver. Further damage by the disease to your body is prevented. The loss of protein in urine will stop, and beside this, cholesterol and triglycerides recorver to normal levels. But, when the organ damage should be very advanced and an irrecoverable damage should be the case, a limited recovery might be expected after the operation.
When does the disease process settle to normal levels?
The disease, whilst this may vary according to the hormone levels and other measurements, achieves normal and close to normal levels in the period of from 1 week to 3 months.
Is the result permanent?
According to undertaken studies, it is revealed that particularly in patients with high insulin levels the diseases remains under control even 8 to 30 years after the operation, though this may vary depending on the specific operation itself.
Can the operation cause hypoglycaemia (sugar deficiency)?
After the operation, as in every normal human, insulin will increase after eating. The possibility for hypoglycemia occurrence will decrease continuously and be eliminated during the period after the operation.
Will energy loss be experienced after the operation?
You will recorver your old energy by the diet list supplied to you and exercises within a couple weeks after the operation. But situations like weakness, anorexia, poor motivation can be experienced during the first 1-2 weeks after the operation.
Does Metabolic Surgery have effects on cholesterol and tension, too?
Between 75% to 99% of the problems such as hyper-tension, high cholesterol and triglyceride levels, liver lipidosis, obesity, bone and joint problems and occlusive sleep apnea can be eliminated at once with the performance of tis operation.
I have weight problems, too. Will the operation be a solution for this, too?
Yes. You will reach your normal weight because of the operation. This, whilst varying depending on the individual, may take 1-1.5 years.
Even during the post-operative period, please take your diabetes controls serious. Reduce stress in your workplace, take balanced nourishment and do regular exercise for a long and healthy life.