Type 2 diabetes is a disease frequently observed in connection with the increasing cases of obesity in today’s world. Excessive weight is one of the main causes of this disease, necessitating the use of insulin. While medical treatments generally focus on controlling blood sugar, they do not often lead to complete recovery. However, in recent times, metabolic surgical procedures have started to play a significant role in the treatment of type 2 diabetes. These surgeries can significantly improve patient health and reduce the need for insulin. Therefore, metabolic surgery emerges as a promising approach in the treatment of type 2 diabetes.

What Is Type 2 Diabetes Surgery?

Type 2 diabetes is generally a health problem associated with obesity. According to Alison H. Affinati, metabolic surgery appears as an effective method in the treatment of this disease. In this condition where insulin production exists but is ineffective, metabolic surgery ensures the effective use of insulin. This surgery plays a significant role in controlling diabetes. Additionally:

• In obese individuals, since hunger hormones are secreted more, portions increase, and the necessity for frequent meals arises.
• Metabolic surgery reduces the secretion of this hunger hormone in the stomach, leading individuals to eat less.
• Moreover, with changes in the size of the small intestine, it helps in more effective secretion of the GLP-1 hormone.

Thus, metabolic surgery can control both obesity and type 2 diabetes. Insulin resistance and the progression of diabetes are prevented, while the quality of life for patients improves. This method has become a promising option in cases where medications and other treatment methods fall short.

Who Is Suitable for Type 2 Diabetes Surgery?

Metabolic surgery is a significant method in the treatment of type 2 diabetes, but it is not suitable for every patient. It is ineffective, especially for Type 1 diabetes patients because, in this case, the pancreas does not produce insulin. On the other hand, individuals with type 2 diabetes are ideal candidates for metabolic surgery. The prolonged duration of this disease can lead to a decrease in insulin production in the pancreas. Therefore, before the surgery, the patient’s insulin level in the pancreas should be measured. C-peptide levels are examined through a blood test for this measurement.

• An important criterion to be considered in patient selection is the body mass index (BMI).
• To benefit from metabolic surgery, the patient’s body mass index should be at least 35.
• Patients who do not respond to medical treatment and have a BMI above 30 are also suitable candidates for this surgery.

Selections made by considering these criteria increase the success of the treatment and help determine the most suitable treatment method for patients.

How Is Type 2 Diabetes Surgery Performed?

Commonly used in the treatment of type 2 diabetes and obesity, sleeve gastrectomy surgery is based on the removal of a large part of the stomach. With this operation, the volume of patients’ stomachs is reduced to make them consume less food. Simultaneously, by removing the region where appetite-suppressing hormones are secreted, the feeling of hunger decreases. With this widely used method, patients’ appetite is controlled, and the progression of type 2 diabetes is prevented.

• SJIT (Sleeve and Jejunoileal Transit)

In this method, in addition to sleeve gastrectomy, a special passage is created in the small intestine. The advantages of the operation can be listed as follows:

• • Rarely requiring iron and vitamin supplements,
  • Rapid weight loss,
  • No need for insulin use,
  • Reduction in diseases such as sleep apnea, reflux, and hypertension,
  • Normalization of cholesterol levels.

• Transit Bipartition

Transit bipartition is a procedure performed in addition to sleeve gastrectomy. With this operation, most of the consumed foods pass through a newly created connection point in the small intestine for absorption. This method contributes to the control of type 2 diabetes by optimizing food absorption.

• Gastric Bypass

Gastric bypass is an effective method in controlling type 2 diabetes. Food consumption is reduced, and absorption is minimized with changes made in the stomach and small intestine. This operation achieves rapid weight loss by bypassing a significant portion of both the stomach and the small intestine. The difference between gastric bypass and sleeve gastrectomy is that the intestines are bypassed to reduce absorption, and the sizes of the stomachs are approximately reduced in the same proportion. Long-term vitamin and mineral supplementation may be required after gastric bypass.

• Ileal Interposition

Another method of metabolic surgery, ileal interposition, is based on the exchange of the starting and ending parts of the small intestine. This surgery contributes to the treatment of type 2 diabetes by regulating hormone balance. Ileal interposition is generally applied together with sleeve gastrectomy and provides effective results by reducing insulin resistance.

These surgical methods play a significant role in the treatment of type 2 diabetes and obesity. Each method has its own advantages and application methods. Selecting the most appropriate method based on the patients’ conditions increases the success of the treatment. These surgeries are effective in both weight control and preventing the progression of diabetes. In conclusion, metabolic surgery emerges as an innovative and effective approach in the treatment of type 2 diabetes.

How Much Does Type 2 Diabetes Surgery Cost in Turkey and Other Countries ?

The cost of  type 2 diabates surgery in Turkey ranges from 3,000 to 4,000 euros ( all-inclusive-package option). Price of gastric sleeve is rougly %70 is cheaper in comparision;

What Are the Risks of Type 2 Diabetes Surgery?

Metabolic surgery is a significant method in the treatment of type 2 diabetes. While these surgeries attract attention with high success rates, they also come with certain risks, as is the case with any surgical procedure.

Firstly, the risks that may be encountered in the postoperative period are as follows:

• Approximately 0.9% risk of bleeding,
• 0.3% risk of clotting problems,
• 0.3% risk of stricture problems,
• 1-2% likelihood of leakage,
• Problems related to anesthesia and, rarely, a 0.2% risk of death.

In addition to these, the long-term effects of the surgery should also be considered. These effects include conditions such as hernia, diarrhea, vomiting, ulcers, reflux, and intestinal obstruction. However, the incidence of these risks is quite low within the general patient population. Metabolic surgery stands out as a promising option with a high success rate (95%) in the treatment of type 2 diabetes.

Can type 2 diabetes be reversed or cured permanently?

Type 2 diabetes cannot be cured permanently; however, it can be reversed. Reversing the condition involves meticulous management of blood sugar levels so that medications might no longer be necessary.

Nevertheless, maintaining this reversal requires persistent adherence to a healthy diet and regular exercise. If these healthy habits are not sustained, the individual’s condition can regress to its previous diabetic state.

How successful is diabetes surgery?

Diabetes surgery is highly successful in inducing remission of type 2 diabetes. According to research, the resolution rates post-surgery are impressively high, with 98.9% for biliopancreatic diversion or duodenal switch and 83.7% after gastric bypass.

Additionally, the Swedish Obesity Study reports a diabetes remission rate of 72% at 2 years and 37% at 10 years post-surgery. Moreover, another research found that 89.5% of patients with a BMI less than 35 kg/m2 achieved euglycemia at 1 year following gastric bypasss surgery.

Is Turkey a good country for type 2 diabetes surgery?

Turkey offers a viable option for type 2 diabetes surgery due to several factors. Firstly, the cost of surgery in Turkey is typically lower than in the United States or other developed countries.

Turkey houses many reputable hospitals and clinics that specialize in bariatric surgery. But selecting a facility that is accredited by a reputable organization and staffed with experienced surgeons is really important.

Which type of diabetes, type 1, or type 2, can be treated with surgery?

Type 2 diabetes can be treated with surgery to potentially put it into remission. This approach involves significant weight loss, which can sometimes be achieved through surgical methods.

The surgical treatment aims to reduce blood sugar levels to a point where the condition is no longer active. Surgery is not a common treatment for type 1 diabetes, which requires insulin management.