Diabetes mellitus type 2 is a chronic disease that requires medical treatment. There are patients who present non-adequate responses to the medical treatment that may be candidates for surgery. Diabetes usually is resolved or improved a few weeks after surgery, long before the complete loss of excess weight.
Relation with the obesity
The clinic and epidemiological experience has proved an undeniable association between obesity and diabetes mellitus. Moderate degrees of obesity may elevate the risk of diabetes up to 10 times and the risk increases when the obesity degree rises.
The relation is linked to the obesity type, depending on the distribution of body fat; it is larger in central obesity type. In turn, the weight reduction of an obese diabetic improves remarkably their metabolic condition, facilitating the glycemic control by reducing the insulin resistance.
Metabolic surgery relates to a diabetes improvement long before a significant loss weight exists.
It has been observed that after surgery, by favouring the weight loss, the patients improve diabetes mellitus type 2 in addition to arterial hypertension or sleep apnea.
Metabolic surgery allows a survival improvement by reducing the risk and mortality from cardiovascular or cerebrovascular cause.
Surgery indications for Diabetes mellitus type 2
Diabetes mellitus type 2 is a disease of medical treatment, although there are patients who may be candidates for the called metabolic surgery:
1- Patients with a body mass index equal or greater than 35 kg/m2.
2- Patients with a body mass index between 30 and 34 kg/m2 with the following characteristics:
-Age between 18 60 years,
-Less than 10 years of evolution diabetes mellitus type 2,
-Diabetes mellitus type 2 difficult to control with medical treatment,
-“Pancreatic reserve” presence demonstrated by analytical determinations: Insulinaemia, HOMA, Peptide C.