Diabetes causes morbid obesity! Surgery should be evaluated

Although gastric bypass surgery is effective in controlling blood sugar in morbidly obese diabetic patients, many doctors believe that this surgery is too drastic and will be accompanied by side effects such as anemia and osteoporosis. Unless it is necessary, it is better not to try it.

Bariatric surgery can be divided into two major types: restricting food intake and reducing absorption. The type of surgery that reduces absorption is gastric bypass surgery.

Bariatric surgery can be divided into two major types: restricting food intake and reducing absorption. Among the most commonly performed surgeries, the type that restricts food intake is gastric banding and sleeve gastrectomy, while the type that reduces absorption is gastric bypass surgery. Wang Wei, director of the Weight Management Center at Taipei Medical University Hospital, said that gastric bypass was proposed by Professor Mason of the United States in 1967 and was first successfully performed laparoscopically by Dr. Wittgrove in 1994.

The surgery mainly involves dividing the stomach into two parts, the small stomach has a capacity of only 20-30 cc. After the stomach is divided, the small intestine is bypassed by 150 cm and connected to the small stomach, and the small intestine passage for bile and pancreatic juice is reconstructed. This achieves the dual effects of reducing food intake and shortening absorption length.

After gastric bypass surgery, if the weight in excess of ideal body weight is used for calculation (ideal body weight is calculated as BMI=22), an average of 65% of excess weight can be reduced in the first year after surgery, and 75% in the second year; the weight will reach the lowest point in the second to third years and remain at that point. Some patients will experience a slight weight gain, but will not return to their original weight. Based on the results of large-scale surgery, the mortality rate of this surgery is 0.3%, and the complications are 5% (including anastomotic leakage, intestinal obstruction, wound infection, etc.).

However, Dr. Wang Wei reminded that about 80% of type 2 diabetes in Taiwan is caused by obesity. If you can eat less and control your weight, your blood sugar level will drop significantly. For those patients with diabetes caused by obesity, doctors recommend that they return to basics and start with diet control and regular exercise. If that doesn't work, they should take blood sugar-lowering drugs or inject insulin as prescribed by the doctor. When these methods have failed and the person is morbidly obese, surgical treatments such as gastric bypass surgery may be considered.