Ahmedabad: Doctors at the Asian Bariatrics Hospital in Ahmedabad performed the first metabolic surgery in a non-obese patient to cure uncontrolled diabetes.The surgery was performed on a 46-year old woman from Karnataka who had started developing kidney related complications due to uncontrolled diabetes. Despite taking insulin and multiple medications, her three month average blood glucose levels remained at a high 9.4 which should be less than 6.
"Metabolic surgery can help a big number of diabetics struggling in India with uncontrolled diabetes despite taking medications including insulin, diet and exercise. Surgery can help lessen the burden of complications of heart attack, kidney failure, stroke, neuropathy and retinopathy in such diabetics", said leading metabolic surgeon from Hyderabad Dr Surendra Ugale who led the operating team. He has the largest series of over 400 metabolic surgeries performed on non-obese uncontrolled diabetics in India since 2008, being the 2nd person in the world to do this.
In the metabolic surgery which is also called Laparoscopic Illeal Interposition with diverted sleeve gastrectomy, the stomach size is reduced by around 40% and small intestine rearranged in a way that body is enabled to produce maximum hormone GLP1 which optimizes beta cells of pancreas to produce more insulin.
"After reducing the stomach by 40%, the initial portion of the small intestine is directly connected to the terminal end of the intestine which enables undigested food to come directly into the intestine's last part helping produce maximum GLP1 which in turn enables body to produce optimal insulin. This automatically helps in better sugar control", explained leading bariatric surgeon Dr Mahendra Narwaria of Asian Bariatrics Hospital.
He said that unlike the earlier surgery-- the duodenal switch wherein large part of the intestine was bypassed thereby creating nutrition mal-absorption issues-- the metabolic surgery works best for non-obese patients as it involves very little bypassing of intestine but its rearranging in a way to best control sugar levels.
"The success rate which was 70% earlier has improved to 90% as we continuously refine the surgery", said bariatric surgeon Dr Sanjay Patolia.
In Gujarat, nearly 18-20% adult population suffers from diabetes- 55% of which have already developed complications at the time of diagnosis. World over, one person dies of diabetes related complications every second.
"Surgery can help patients for whom insulin is not working", said Dr Ugale. The surgery has a complication rate of around 6.4 per cent, which is comparable and less than other surgeries.
Patients should be aware that when their diabetes is worsening, they now have an option to get rid of it through this surgery; this should not be seen as a last resort, and the earlier they have it done, the better the results.
We do not offer this surgery for persons who are able to control their diabetes with diet, exercise and few medicines. We definitely need more support and patient encouragement, from physicians and diabetes specialists, so that patients do not hesitate to go ahead with surgery at the right time, before their pancreas gets badly destroyed.