We treat patients with type 2 diabetes using surgical methods. This is called Metabolic Surgery. The classical treatment algorithm of type 2 diabetes is education, diet, exercise and medication use. However, despite all these treatments, the disease is sometimes progressive. Despite the intense use of insulin, desired results cannot be obtained. In this case, Metabolic Surgery should come to the agenda as an effective treatment alternative.

Of course. Type 1 and type 2 diabetes are completely separate diseases. There is no insulin production in type 1 diabetes. In type 2 diabetes, the body produces insulin but cannot use it. We can only help patients with type 2 diabetes. In other words, we ensure that the body uses insulin that it cannot use.

Type 2 diabetes is a multifactorial, heterogeneous and dynamic spectrum of diseases. It is a process in which not only hormonal but neural, psychogenic and environmental factors are also effective. The cornerstones of classical therapy are diet and exercise. However, no one can diet and exercise for whole life. In fact, the proportion of patients who can only diet and exercise at the desired level for 3 years is not above 5% in any research. Medication treatments are not intended to change the general course of the disease, but are “saving the day” treatments. If we want to effectively combat type 2 diabetes and related loss of organs and workforce in appropriate patients, we need to apply more radical but rational treatments.

In type 2 diabetes, medium- and large-scale vascular damage begins before the disease is diagnosed. Already, a significant number of patients are considered to have a 2-3 year history of disease at the time of diagnosis. Imagine, as soon as you get a diagnosis, you already have an impact on your veins. However, type 2 diabetes generally has a moderate course. So, a significant part of the complications gradually manifest over the years. For this reason, it is also defined as “insidious” disease.

In the follow-up of a type 2 diabetes patient, it is generally accepted to consume their own insulin reserves over a period of 10-12 years, and after this period, signs of organ damage begin to manifest themselves. This is the period when patients generally apply for treatment. Most patients do not want to have surgery while things seem to be fine. In summary, in order for us to help a diabetic patient with surgery, they should either not be able to control their sugar with standard treatments or have signs of organ damage. Of course, applying without loss of organs and before the insulin reserves are exhausted has many positive consequences.

It is their own reserve and activities that determine the extent to which a type 2 diabetes patient will benefit from this surgery. The more sugar resistance hormone reserves available and the higher the activity, the higher the chances of success. However, the most important point to remember is that diabetes has hormonal, nervous and psychogenic bases. These surgeries only treat the hormonal aspect of diabetes. There will be a fluctuation in blood sugar when a patient with whom you provide hormonal control with a very crude expression is upset, delighted, angry for any reason. In fact, such fluctuations occur in individuals without diabetes.

However, the duration and severity of the fluctuation are smaller in non-diabetic patients. After the operation, this fluctuation will be lighter and will return to normal in a shorter time. Type 2 diabetes is a dynamic disease with a variational course over time. The important thing is the 3-month average blood glucose values and the presence of organ damage. From this point of view, more than 90% of patients will be controlled over a 10-year period.