Did you know? ... Diabetes Mellitus can be cured with an operation! Diabetes, along with obesity, are considered the most devastating epidemics in the contemporary world.

• Mexico ranks 8th place in the world in number of people with Diabetes Mellitus.

• Approximately 1 in 10 adults in Mexico has Diabetes. Up to 3 out of 10 individuals with morbid obesity are affected by this disease.

• Approximately one tenth of the health budget is used to treat diabetes and its complications.

• People who are overweight spend 25% more on health services, earn 18% less and suffer more absenteeism from work.

• Premature death in patients with type 2 Diabetes Mellitus increases up to 80%.

• Life expectancy is reduced between 12 and 14 years.

   

What is the role of Bariatric / Metabolic Surgery in the treatment of Type 2 Diabetes Mellitus?

• The effect of various bariatric procedures on Diabetes Mellitus has been extensively studied. The observed benefits occur in two main ways:

1) Dependent on weight loss:
The patients that undergo a bariatric intervention experience a pronounced and accelerated weight loss. This improves the way the body uses insulin, a hormone responsible of stimulating cells to absorb and use the glucose circulating in the blood.

 2)  Independent of weight loss:

Bariatric / metabolic operations cause various changes in the production and release of hormones related to glucose control. Hormones such as GLP-1 and GIP, significantly increase their levels in people who undergo surgeries such as gastric bypass. Higher levels of these translate into a greater amount of circulating insulin, a better use of insulin by the white tissues, greater preservation of the integrity and function of the pancreas (organ responsible for the production of insulin), among other endocrine phenomena.

It is interesting to note that most diabetic patients normalize their glucose levels within 72 hours of having surgery, even before they lose the first kilogram of weight.

Around 90% of patients that undergo some type of Bariatric / Metabolic Surgery improve their diabetes in varying degrees. This is accomplished through:

1) Decreased blood glucose.
2) Reduction or suspension of medications that decrease and control glucose and / or insulin.
3) Improvement in collateral diseases of diabetes.

Approximately 80% of individuals experience a complete remission of their diabetes, normalizing their blood glucose levels without the use of "anti-diabetes" medications or insulin.

A small percentage enjoy partial improvement (dose reduction, an easier achievable control, etc.).

Bariatric / Metabolic Surgery works best in patients whose diabetes appeared less than 10 years ago, have adequate pancreatic reserve, do not depend on high doses of insulin.

All Bariatric procedures have an effect on diabetes, however, not to the same degree. The adjustable gastric band, for example, provides some improvement, however, its effect on diabetes is solely dependent on the amount of weight that is lost. On the other hand, surgeries that involve the reconfiguration of the intestinal anatomy have a much more powerful effect in this regard. Therefore, the most favored surgery in this area is the gastric "bypass", since it has a powerful "anti-diabetes" effect, without considering a procedure as radical as the Duodenal "Switch".

It is traditionally considered that patients who are candidates for this type of procedure with the primary intention of treating diabetes must have a Body Mass Index (BMI) greater than 35 kg / m2