What is Metabolic surgery?

Today, we will learn what is Metabolic surgery, and what is its mechanism that makes it effective in treating type-2 Diabetes? Metabolic surgery is a laparoscopic procedure that does not include big incisions, but rather 3-to 4 small incisions are made. In a metabolic surgery, the capacity of the stomach is reduced by a laparoscopic procedure, and bypassing a part of the intestine. Also known as a Gastric Bypass, this procedure is used in treating diabetes and helps in the reduction of complications that usually arise in type-2 diabetes.

To understand how metabolic surgery, by reducing the capacity of the stomach or by bypassing a part of the intestine helps in the treatment of type-2 diabetes, we first need to know what is type-2 diabetes. Type 2 diabetes does not occur due to any deficiency or due to overproduction of insulin in the body; the body is perfectly producing insulin. Type 2 diabetes occurs because the insulin that is being formed in the body is unable to work properly. There are 2 important reasons why insulin cannot function properly. The first reason is the presence of visceral fat, that is, the fat deposited on the liver, stomach, spleen, and various other organs of the body. This particular fat does not allow the insulin to work and hence, creates a layer of obstruction between the insulin and the receptors, on which the insulin works. The second reason is the presence of various anti-insulin hormones which do not allow the insulin to function. These anti-insulin hormones create insulin resistance, they are against insulin, and they do not allow the insulin to work on its receptors which, in turn, decreases the blood glucose level. Hence, the insulin does not work, and the sugar levels keep on increasing. Many such anti-insulin hormones are being produced in the type 2 diabetes patient’s body. The metabolic surgery decreases the levels of these anti-insulin hormones by several modifications that are done in the gel track by laparoscopy. It also decreases the amount of visceral fat inside the body by moderate weight reduction, thereby decreasing insulin resistance.

Thus, through metabolic surgery, a laparoscopic procedure and not a radical surgery, by causing gel track modification, we decrease the visceral fat and the anti-insulin hormones which cause insulin resistance, and increase the pro-insulin hormones, thereby increasing the availability of the hormones which support insulin. This results in decreasing the resistance to the insulin that makes the body effective in working to decrease the blood glucose level. Metabolic surgery helps the insulin to work in a much better, more effective way and optimises it to levels that there is no need to give external medications and injectable insulin pens.

Thank you.

Author: Mohit Bhandari

Mohit Bhandari is a renowned Indian bariatric surgeon and globally recognized for his contribution in Laparoscopic and Robotic surgeries.

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