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Obesity and Diabetes

Obesity refers to accumulation of excessive fat in the body. Obesity is a progressive disease which shortens life expectancy and is associated with a wide range of medical problems. An obese person has double the risk of developing diabetes, and a severely obese person has ten times the risk. Too much abdominal or belly fat is associated as a defect in body’s response to insulin. Insulin hormone has a vital role in our body to regulate blood sugar. Excess fat can cause resistance to insulin hormone.

Bariatric surgery or weight loss surgery includes a variety of procedures performed on people who are obese, to achieve meaningful, sustained weight loss and resolution of diseases related to obesity. The procedures involve surgically manipulating the stomach to reduce food intake and in some cases to reduce the absorption of calories. Below are the three most common types of bariatric surgery:

  1. Laparoscopic Sleeve Gastrectomy
  2. Laparoscopic Gastric Bypass
  3. Laparoscopic Mini Gastric Bypass

A study conducted by Cleveland Clinic, USA published in March 2014 with data from 3 year follow up of 150 patients, shows that at least 5 times more surgery patients achieved normal blood sugar levels than intensive medical therapy patients, and with far fewer medications. Sangeeta Kashyap, M.D., one of the lead investigators and an endocrinologist at Cleveland Clinic’s Endocrinology & Metabolism Institute said More than 90 percent of the patients who underwent bariatric surgery were able to lose 25 percent of their body weight and control their diabetes without the use of insulin and multiple diabetes drugs.”

Case History: Bariatric Surgery for Patient with Renal transplant and uncontrolled Diabetes

Patient aged 46 years, had undergone renal transplant in 2007, post which he started gaining weight gradually. Now, he weighed 117kgs and had reached BMI of 40, making him morbidly obese with uncontrolled diabetes even on high doses of insulin. His creatinine levels had also started rising. The increase in his creatinine levels was an indicator that kidneys were now getting affected.

A senior nephrologist and transplant specialist (Br M M Bahadur) at Jaslok Hospital advised him to undergo Bariatric surgery for weight loss, which will help him to control his sugar and creatinine levels. The patient opted for Laparoscopic Sleeve Gastrectomy surgery at XXX hospital by Dr Manish Motwani

Five months post bariatric surgery, the patient has already lost 28kgs and his weight is now 89kgs. His sugar levels are normal and he is off Insulin. His Blood pressure is normal even without medications. Most importantly, the creatinine levels, which were endangering his transplanted kidney, are also normal. Thus, at XXX Hospital, Bariatric Surgery not only helped him reduce his weight drastically, but also helped him get rid of Diabetes, high blood pressure and also helped him save his transplanted kidney.

Obesity, insulin resistance, metabolic syndrome and type 2 diabetes have reached epidemic proportions. Yet as common as these conditions are, few people understand how closely they’re related to one another.

It is now clear that not only do these conditions share the same underlying causes– and thus require the same treatment – they are 100% preventable and, in some cases, entirely reversible.

Diabesity is a constellation of signs that includes:

  • abdominal obesity (i.e. “spare tire” syndrome);
  • dyslipidemia (low HDL, high LDL and high triglycerides);
  • high blood pressure;
  • high blood sugar (fasting above 100 mg/dL, Hb1Ac above 5.5);
  • systemic inflammation; and,
  • a tendency to form blood clots

Bariatric Surgery is a safe procedure and time tested surgery. With technological advances, the risks in procedure have gone down tremendously and risks in surgery are negligible compared to the risk of not getting operated.

‘Aastha Health Care’ is a premier institute for Laparoscopic Weight Loss Surgery. Aastha Bariatrics has created a place for itself as a leading destination across the globe for Bariatric Surgery.

 

Dr Manish Motwani

Bariatric Surgeon – ‘Aastha Health Care’

 

 

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