Dr.Tulip's Obesity & Diabetes Surgery Centre

Hi,

My name is Dr. Tulip. I am a Bariatric and Laparoscopic Surgeon practicing at Doctor Tulips Hospital, 4th block, Koramangala.

Why do we need to go on to a diabetic surgery? Because diabetes even though under control with medications over years cause a lot of complications like all of us know. Complications for the heart, complications for the kidney, for the eyes and so on. And India being the diabetic capital, you will find many diabetics , they may not be obese but the diabetics. And the severity of diabetes is higher in our population which means we get complications at very early age after a few years of diabetes.

So, if you undergo this metabolic surgery, you are out of diabetes and you can protect yourself from the complications of diabetes.

Hi!

This is Dr. Tulip. I am a Bariatric and Laparoscopic Surgeon practicing at Dr. Tulip Hospital, 4th block, Koramangala.

We all know that once a diabetic , always a diabetic. But now we have something called as metabolic surgery by which one can be totally free from Diabetes. I mean you can stop your diabetic medications and still your sugar can be in normal limits. You don't need to take any oral diabetic medications and you need not take any insulin. But is this surgery helpful for all types of diabetics? No, we need to be a little careful and a little choosy about this. This surgery is good for, it helps Type 2 diabetics.

Type 2 Diabetics are those people who develop diabetes after the age of 30. They don't have a family history like their parents, grandparents would have had diabetes but those people who develop diabetes in childhood or in their teens less than 30 years are most likely to be Type 1 diabetics wherein the body is not secreting any insulin, the pancreas is not having any insulin to secrete, wherein the surgery the metabolic surgery will not help. Now, is every type 2 diabetic eligible for this surgery? Yes , but we also need to see the amount of pancreatic reserve that is present in that patient. For example, if the patient is suffering from diabetes for 4 to 5 years, the reserve will be much better.

But if they're suffering from diabetes from 15 to 25 years, then the reserve will be a little less and hence the results may not be very good. But all said and done, the results will definitely better. Now, how do we check the pancreatic reserve? There is a blood test which is called as the C-peptide. When we assess this value, if it is more than one, that means the pancreas has a good reserve and the results would be very good. Now how early do we expect the person to be free from diabetes after the surgery?

Even as early as 24 hours after the surgery, the person can be free from diabetes. Now, in some cases where the pancreatic Reserve is not very good then the patient might have to take one tablet, one oral hypoglycemic, maybe for a month or two and then the person can get totally out of diabetes.

Hi!

This is Dr. Tulip. I am a Bariatric and Laparoscopic Surgeon practicing at Dr. Tulip Hospital, 4th block, Koramangala.

Now this surgery for diabetes is called the metabolic surgery. This is done through tiny holes over the tummy so we need not cut open that tummy and what is done if we operate on the stomach and the small intestine. It is called the gastric bypass. So what is happening in the surgery? We divide the stomach into small portions and this small portion, a small pouch, is attached to the small intestine. Which means we are diverting the food directly from the small gastric pouch into the small intestine.

So majority part of the stomach and small intestine , who doesn't enter. How does this help us? Because we are by passing that second part of the deodenum the second part of the deodenum, the harmful factor, the deodenum factor is not released because this is released only when the food touches that part of the stomach of the intestine. Other thing is what we achieved by these bypass is, the food touches, reaches rather, this lower part of the small intestine which is called the idiom which is very early compared to normal and this causes release of the glp 1 hormone normally in three times more than normal.

Now, what happens by this? This hormone is very good for the pancreas it stimulates the pancreas and does define class starts working in a much better way and more insulin sensitization occurs. Normally in type 2 Diabetics we have insulin resistance. So by doing this bariatric surgery when we do the manipulation the hormones, Dipankar starts working better and the person gets out of insulin resistance. So much so that the very next day of surgery, the patient is totally out of diabetes. This is nearly like a wonderful but we do need to take care, we need to make sure the patient of the type 2 diabetic as good pancreatic reserve and is not underweight. We don't do the surgery for underweight people. The person should be either overweight and obese.