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Top ten questions about diabetic surgery


1. How to reduce blood sugar for surgery

“Diabetes surgery”, specifically, this type of surgery generally refers to “shrinking stomach” surgery. It uses surgical surgery to reduce gastric volume or change the intestinal direction, thereby reducing food digestion and absorption. Gastrointestinal hormones change, increase insulin sensitivity, and eventually achieve the effect of lowering blood sugar.

The surgical treatment of diabetes is the fourth diabetes treatment method after lifestyle changes, oral drugs, and insulin treatment. Research in recent years has found that it will bring very great benefits to patients with very clear indications. However, this surgery cannot be blindly followed, and you must choose carefully according to your own condition to determine whether surgery is required.

2. Why do hypoglycemic move “knife”

Speaking of diabetes, we first think of controlling diet, strengthening exercise, hypoglycemic and insulin. However, for some diabetic patients, the relief rate of traditional treatment methods is not high, and the symptoms cannot be well controlled. For example, some patients with severe obesity, even if they have a large dose of insulin, or have been treated with three or four drugs with hypoglycemic treatment, blood sugar is still not controlled. Another way to take a different approach, such as surgery.

In addition, diabetes is usually accompanied by obesity. “How can you not reduce fat”, it is easy to become a blockburning and bottleneck in the treatment process. It not only makes patients pain, but also makes it difficult for doctors. At this time, through surgery, on the one hand, patients can end the “pain” weight loss process, increase the confidence of treatment, and avoid the adverse consequences of blind restriction and fasting for weight loss; on the other hand Obstacles are removed, and they can often receive the effect of one fell swoop.

3. Which sugar friends can surgery

In March 2011, the International Diabetes Alliance issued a statement that recognizing weight loss surgery was one of the measures for the treatment of type 2 diabetes, and it was recommended that patients who met the conditions of surgery considering surgical treatment as early as possible. But it is important to note that diabetic surgery is only suitable for some patients.

In the same year, the Chinese Medical Association Diabetes Branch and the Chinese Medical Association Surgery Branch jointly released the “Consensus on Surgical Treatment of Diabetes” (hereinafter referred to as “Consensus”), which clarifies surgical indications suitable for Chinese patient (BMI, that is, the height (kilogram) except for the square height (meter) square meter) patients with type 2 diabetes; 2. 2. 2.

BMI is 30 ~ 35. Limority and drug treatment is difficult to control blood sugar or complications, especially patients with high risk factors with cardiovascular disease; 3.BMI is 28 ~ 29.9, and there are heart obese 90 cm), and at least in line with two metabolic syndrome standards (high glycerin trigly, low -density lipoprotein cholesterol level, high blood pressure); 4.BMI ≥ 40 or BMI ≥ 35, accompanied by severe complication, and age ≥ ≥ age ≥ 15 -year -old, mature bones; 5. Patients with good physical condition and low surgical risk under 60 years of age.

Simply put, it is suitable for patients who receive surgery. The first is young. It is best to be less than 60 years old, no more than 65 years old, and the medical history is within 10 years. Third, it is in line with indications, and the treatment of drugs is not good.

4. What are the situations do not surgery

Surgical treatment of diabetes is not suitable for everyone. The contraindications pointed out in the Consensus include: patients with abuse of drugs, alcohol addiction, or mental illness; patients with clear diagnosis as type 1 diabetes; islet function have basically lost their ability to lose basis Patients with type 2 diabetes; abnormal hemorrhagic diseases or abnormal coagulation function, or cardiopulmonary function cannot tolerate surgical; patients with BMI ﹤ 28 and drugs or insulin therapy can satisfy blood glucose; gestational diabetes and other special types of diabetes patients.

Therefore, patients must go to the hospital for examination, and have been evaluated by a specialist to determine whether they can surgery and methods. The key principle of choosing is to follow the “Consensus”. Patients who do not meet the surgical indications or have a clear contraindication. Do not follow the trend blindly.

5. How to do hypoglycemic surgery

There are currently three main methods to treat type 2 diabetes through weight loss surgery. The first is the “gastric band surgery”, which is tied to the upper part of the stomach with a adjustable beam band to reduce the accumulation of gastric accumulation. Patients have decreased and their weight is reduced. But this surgical effect is average, and it is currently rarely used. The second is the “sleeve gastric surgery”, that is, cutting all the big bend of the stomach, turning the stomach like a sleeve cover into the lumen of the intestine, which greatly reduces the amount of feeding. It is suitable for simple obesity and early diabetes. Patients, the postoperative relief rate is about 80%. The third is “stomach turning surgery”, which allows the stomach and small intestine to “short circuit”. The effect of this type of weight loss is the best. The diabetes relief rate is about 90%, but the surgery is relatively complicated and the risk is relatively high.

6. How to choose the timing of surgery

Generally speaking, patients should first control the condition from regulating diet and exercise, and then consider drug treatment. When the above treatment effect is not good, surgery can be considered. Of course, the timing of surgery should not be too late. For patients with clear indications, the sooner the surgery, the better. Do not have type 2 diabetes for more than 15 years. The islet function cannot be completely damaged. If diabetic complications have begun, we must actively consider surgery.

7. How risks are the risk of surgery

Any operation is a double -edged sword, which has both advantages, trauma and risk. The main recent complications of weight loss surgery include intestinal obstruction, anastomotic fistula, pulmonary embolism, etc. The main long -term complications include gastric mild, malnutrition, iron deficiency anemia, folic acid deficiency, vitamin B12 deficiency, and stubborn diarrhea. In short, nutritional deficiencies may occur after any type of weight loss surgery. It is best to be guided by nutritionists and follow -up. It also needs long -term changes in lifestyle habits after surgery. At present, the long -term impact of the academic community on the operation is still under evaluation, and the effects of different patients are also large. Therefore, it is necessary to strictly grasp the indications and take it seriously.

8. How long does it take to do the surgical tube

The efficacy of diabetes surgery is mainly based on three principles: First, reduce the stomach, reduce the intake and absorption of energy, use excessive energy reserves in the body to maintain the body balance. This effect is the most obvious within a year. After a year, if a year reaches a balance, the weight will not decrease again. The second is to reduce weight. Patients with a large weight after surgery can decrease by about 30%. Insulin resistance caused by obesity will also be reduced, and blood sugar will gradually return to normal. Third, after gastrointestinal reconstruction, it can regulate intestinal secretion to promote insulin levels, improve the level of islet secretion, and gradually normal blood sugar.

The above three principles so that surgical hypoglycemic can usually take effect quickly. However, surgery cannot directly repair the metabolic function of the body, stimulate the secretion of insulin, or let the damaged islets “rising back to life”. Therefore, it is still necessary to actively treat diabetes after surgery.

9. Can I cure diabetes

So, how effective is the effect of diabetes surgery? Regarding this result, there is no unity at home and abroad. On the whole, the relief rate of diabetes is generally around 80%. Most patients can effectively improve the status of hyperglycemia without having to take medicine or insulin, and the level of blood sugar can be controlled within the normal range. In addition, patients such as hypertension, hyperlipidemia, gout and other metabolic problems caused by obesity can also be improved well.

However, surgery does not benefit all diabetic patients, and the existing evidence is not enough to prove that surgery can completely cure diabetes. Poor surgical effects may be related to the disagreement of indications, or the patient’s postoperative lifestyle has not changed, resulting in recurrence of diabetes.

10. What should I pay attention to after surgery

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“Consensus” believes that diet guidance is a crucial part of ensuring the effect of surgical treatment and avoiding long -term complications after surgery. Therefore, patients should pay special attention to their diet after surgery.

First of all, energy intake should be balanced, do not eat too much. Metabolic surgery will “get smaller” stomach. Patients should adapt to their new appetite. Do not eat too full, avoid eating too hard food, and chew slowly. ~ 30 minutes. Secondly, food should be high -protein, low calories, low sugar and low fat to avoid high fat food. Third, it is necessary to properly supplement nutrients and minerals. Such as calcium, iron, and various lipid -soluble vitamins. Different surgical methods require different nutrients and minerals. Finally, strictly limit wine, do not drink carbonated drinks. Ensure enough liquid intake every day, but do not drink carbonated drinks to avoid bloating.

In addition, the operation is not a forever and for all, and after surgery, we must persist every three months of follow -up every three months. For women who undergone weight loss surgery, it is best not to get pregnant within one year after the operation.

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