Surgery to treat chronic diabetes?

HYDERABAD: Soon, chronic diabetes patients in the city might take to surgery to beat their fluctuating blood sugar levels. Speaking about this at a conference held on Friday, medical practitioners said that the procedure known as " Ileal interposition with sleeve gastrectomy" would not just help in effectively controlling type 2 diabetes but will also eliminate the need for medication to treat the ailment.

While the procedure, doctors said is not new; it has failed to pick up in the city. Dr Surendra Ugale of Kirloskar Hospital, Basheerbagh, who first performed this surgery in 2008 claimed to have reversed Type 2 diabetes in 225 patients (of the 250 he operated on) in India and Istanbul. "Very few patients had a recurrence of their diabetes at some point," he said, adding that the surgery costs Rs 4 lakh.

A case in point is Meena, a Type 2 diabetic, who was under severe stress till last year as medicines failed to control her blood sugar levels. An episode of hypoglycemia (occurs as a complication of treatment of diabetes mellitus with insulin or oral medications) that left her unconscious for an hour further added to her troubles. Though averse to surgery, the 52-year-old finally went under the knife last year. Ever since, Meena claims that, she has stopped taking the 7-8 pills she needed daily to keep her ailment under check.

Type 2 diabetes mostly occurs due to poor eating habits and a sedentary lifestyle, unlike type1 which occurs due to genetic predisposition.
Doctors however cautioned that the surgery is only for patients with progressive diabetes that impacts the heart, kidneys, eyes, nerves and pancreas. "It is not for patients who can manage their blood sugar levels by exercise, balanced diet and medications," they said.

The procedure involves removing the ghrelin producing area of the stomach. Ghrelin acts against insulin. Then, a section of one of the three parts of the small intestine, the ileum, is cut and placed closer to the stomach. The ileum produces the hormone GLP-1, which helps in insulin secretion. This means food from the stomach takes just 10 minutes to reach the ileum instead of an hour that it is used to take earlier. This reduces the dependence on insulin injections.