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DIABETES AND OBESITY SURGERY

Zulekha Hospital Bariatric Surgery Center for Diabetes and Obesity

The exclusive center for Bariatric and obesity Surgery, aimed to provide holistic healthcare for patients suffering from obesity & metabolic syndromes (like diabetes, hypertension & hyperlipedemia). Every obese individual's needs are different and our group of highly trained specialists analyzes individual specific need and tailors the management protocols that best suits them. With literally all modalities of surgical and non-surgical options available at the center; coupled with our enviable safety record, our patients are indeed assured of a safe journey with us during their weight loss process.

With a dedicated team of specialists, nursing and support staff, Zulekha Hospitals is indeed a world class facility and one of the most advanced Bariatric centers in UAE, with very competitive and reasonable packages .

Book your assessment to fight Diabesity with Zulekha Hospitals – email your enquiry to marketing@zulekhahospitals.com and get your query answered by us.

Surgery for DIABESITY (Diabetes and Obesity)

The most common form of diabetes which accounts for 95 percent of all cases is Type 2 Diabetes Mellitus. In this form of diabetes, the body either does not produce enough insulin, or there is insulin resistance because of which cells are not able to use insulin properly. Insulin is necessary for the body to be able to use glucose or blood sugar for energy. As a result, glucose accumulates excessively in blood which over the period leads to various complications like heart disease, blindness, nerve damage and kidney damage. Type 2 diabetes is the form of the disease which is either associated with obesity to start with or get worsened with weight gain and the name “Diabesity” has been used to describe this association.

Eligibility: Major international medical society and health regulatory authority has outlined various parameters based on which patients are selected for surgery. Consensus among most of regulatory authorities regarding eligibility for surgery, are any patient with

  • BMI more than 40
  • BMI more than 30 with co morbidities like diabetes, hypertension, hypercholesterolemia.

How Type 2 Diabetes is normally treated?

Current therapy for T2DM includes lifestyle intervention including losing excess weight, eating a healthful diet and engaging in regular exercise are the first-line treatments for type 2 diabetes. When not successful, anti-diabetic medications may be needed to keep blood sugar levels from being excessively high, and as disease progresses insulin may be needed. All these treatments offer nothing as far as resolution is concerned and disease keeps progressing. This disease often worsens with time, requiring either higher doses or increased number of medication to maintain blood sugar control

Most of the complications related to diabetes is related to the microvascular changes which diabetes induces in essential organ, microvascular changes is directly proportional to number of years patient is suffering from diabetes. Most of these patients run the risks of long term complications like:

  • Diabetic Retinopathy – the leading cause of blindness in adults.
  • Diabetic Nephropathy – the leading cause of kidney failure in adults.
  • Diabetic Neuropathy – leading cause of non-traumatic amputations of the lower extremities in adults.
  • Cardiovascular Disease – 8/10 patients with type 2 diabetes die of cardiovascular disease.
  • Stroke – 2 to 4 times more likely to have a stroke.
  • Diabetic Foot- which may lead to loss of limb.

Bariatric Surgery for Metabolic Syndrome

Various scientific studies have proven Bariatric surgery apart from inducing weight loss, helps in resolving co morbidities like diabetes, hypertension and hyperlipidemia. As per the current evidence in literature and various scientific studies, it has been proved after Bariatric surgery.

Diabetes gets either completely resolved requiring no medication or improved in 86% of patients. High blood lipids improved in 70% or more of patients. High blood pressure was resolved or improved in 78% of patients.

Beside the indication of surgery, the other important question that remains is when, should the surgery be performed — when diabetes is first diagnosed or down the road, when complications have already begun to rise? It has been proven in scientific studies, it’s always better for surgery to be performed early in disease as the diabetic remissions rate are better , the life threatening complication has not set into the various system of the body.

Weight Loss for Obesity

Over the last decade, weight loss or Bariatric surgery has been continually refined to improve results and minimize risks. Today, Bariatric surgeons have access to a substantial body of clinical data that supports the use of surgery as a safe and effective weight loss treatment when other methods have failed.

Compared to other weight loss methods, such as dieting, surgery provides the longest period of sustained weight loss in patients for whom all other therapies have failed. It has also been shown to improve many obesity related health conditions, such as type 2 diabetes and high blood pressure.

Many patients who have had Bariatric surgery report improvements in their quality of life, social interactions, psychological well-being, employment opportunities, and economic conditions.

Surgical Treatment options available at the Centre

Laparoscopic Adjustable Gastric Banding:

An Inflatable Gastric Band is used, thus creating an hourglass structure to the Stomach. This procedure may lead to about 39% of the excess weight being reduced within 18 months after the surgery. This procedure needs a high level of compliance from patient regards lifestyle and diet post-surgery. There is always a risk of the band eroding into the stomach, slipping out of place, and can also produce vomiting, development of GERD or sometimes the device can also fail to function.

Laparoscopic Sleeve Gastrectomy:

In this procedure, 75 % of the stomach will be removed along the greater curvature of the stomach starting from 6 cm away from the pylorus all the way up to the gastro-esophageal junction. Subsequently, the patient has a new tube-shaped stomach with a capacity of one quarter of the regular amount of food. Digestion and absorption is normal. By eating less the body draws the required energy from its own fat stores and thus you lose weight. There had been concern regarding staple line leak, but with advent of technology it has been reduced to minimal.

The Roux-en-Y Gastric Bypass – The Gold Standard procedure:

In this procedure, a small, 25-30 cc, pouch is created at the top of the stomach; below the gastro- esophageal junction to create a small pouch. The small pouch will be connected to the small bowel, jejunum at a distance of 150 cm away from Treitz ligaments, (anatomical figure). Thus, food will pass through the small pouch to Jejunum without passing the rest of the stomach and duodenum. This surgical process will create an early satiety feeling after eating a small amount of food to fill the small new pouch. Also, this bypass may result in a partial reduction in the absorption of food. Long term nutritional malabsorption is always a risk but it could be easily overcome by nutritional supplement.