Bariatric surgery bringing hope for diabetics

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By Anjali Ojha, New Delhi, Nov 13 : For 58-year-old Delhi resident Narendra Gupta, life took a new turn when he was able to go off diabetes medication after 15 years. Though nothing short of a miracle for him, this was possible by a simple bariatric surgery, commonly known as weight reduction surgery

Gupta weighed 110 kgs before he went for the procedure around a month back. Since then, he has shed 13 kgs, apart from being totally off diabetes medication.

"A relative of mine told me that the surgery will help solve a lot of problem, and my health is much better now," says Gupta.

Traditionally meant for weight reduction, more and more people are now going for the surgery to get rid of lifestyle diseases.

"'Diabesity' is the newest term, which is a combination of diabetes and obesity," says Atul Peters, director of minimal accesses, metabolic and bariatric surgery at Delhi's Primus Superspeciality Hospital.

"Nearly 80 percent of diabetes is related to obesity. Obesity is also the second biggest cause of cancer after smoking," he says.

Costing around Rs.2.5 to 3 lakh, the surgery has emerged as a major relief for many, actually reversing type-II diabetes in most patients.

"Traditionally, the only treatment for diabetes was lifestyle modification, but this surgery is now coming up as an effective cure for diabetes in obese people" says Yogesh Agarwal, senior consultant of surgery at Fortis Hospital in Noida.

With an estimated 50.8 million people living with diabetes, India has the world's largest population of diabetics, followed by China with 43.2 million.

According to the World Health Organisation (WHO), an estimated 285 million people, corresponding to 6.4 percent of the world's adult population, were diabetic in 2010. The number is expected to grow to 438 million by 2030.

Diabetes is also one of the major causes of premature illness and deaths worldwide. Non-communicable diseases, including diabetes, account for 60 percent of all deaths globally.

"In 2008, adult population with a BMI (body mass index) of above 30 in India was 2.8 percent, which means 15,00,000 people were obese," says Peters.

BMI, which is calculated by dividing one's weight by the square of the height, gives the individual's obesity level.

Doctors say type-II diabetes can be reversed with bariatric surgery.

"Bariatric surgery is also called metabolic surgery because it has very good effect on diabetes. We have seen reversal of diabetes in 80 to 90 percent patients," he told IANS.

The surgery reduces the size of stomach through different methods.

"Bariatric surgery is done through three methods, by implanting a band around the stomach (gastric banding), through removal of a portion of the stomach (sleeve gastrectomy or biliopancreatic diversion with duodenal switch) or by making a bypass resecting and re-routing the small intestines to a small stomach pouch (gastric bypass surgery)," says Agarwal.

"This surgery is not removal of fat. It is a minimal invasive surgery by which we reduce the size of the stomach.

"This changes the path of food and it reaches the intestine faster. Due to shorter transit time, absorption of fat is reduced.

"Since the size of stomach is reduced, the patient is able to take less food, which helps in reducing weight," says Agarwal.

According to doctors, in maximum cases, the medication for diabetes is either not required anymore or is reduced significantly.

"In type-II diabetes, insulin is there, but it is not utilised by body. After this surgery, some hormones are generated which activates production and utilisation of insulin, making diabetes disappear," says Peters.

Doctors say there has been a steep increase in the number of patients undergoing the surgery.

"In 2006 in India, a total of 200 bariatric surgeries were done. Now, it is more than 4,000 per year," Agarwal adds.

The doctors add that the surgery is performed only on those with a BMI of above 33. Weight loss happens upto one-and-half years after the surgery, and nearly 90 percent of the excess weight is lost.

(Anjali Ojha can be contacted at anjali.o@ians.in)
 

--IANS http://www.newkerala.com/news/2011/worldnews-105740.html