Gastric surgery last resort
Surgery can be performed only on patients with BMI of 33 and above
Hyderabad: The gastric bypass surgery performed on Union finance and defence minister Arun Jaitley is possible only for people whose Body Mass Index is 33 and above.
Diabetes has to be managed first with medications, changes in diet and exercise. If these can’t control the disease, only then is surgery an option.
However, the criteria of BMI means that it can only be performed on obese and not lean patients.
The news of the surgery has made many diabetic patients curious but experts caution that it is not for all. It is not advisable for those who have been suffering from diabetes for 20 years. Better outcome is seen in patients who have suffered from diabetes for less than 10 years and are not progressing towards requiring insulin.
The laparoscopic gastric by-pass surgery involves stapling of the stomach to create a small pouch so that a small amount of food satiates one’s appetite. This pouch is connected to the small intestine to lower fat absorption.
Consultant endocrinologist, Dr V.S. Nagesh said, “Surgeries like these are undertaken when the complications are continuous and the impact on the body is leading to damage of blood vessels and disorders of the retina, nerves, kidneys or heart. When medicines do not bring the desired results and the disease management becomes progressively difficult, than these surgeries can be opted for.”
Minister of road transport and highways, Nitin Gadkari, underwent this surgery two years ago. Mr Jaitley is 61-years-old and doctors say it is not such an advanced age. Patients up to 75 can undergo the surgery if they are found to be clinically fit.
Dr K.S. Lakshmi, senior consultant for bariatric and metabolic surgery at Global Hospitals, said, “Bariatric or metabolic surgery brings about several metabolic changes which decrease the insulin resistance and improve insulin secretion that helps to control diabetes and metabolic syndrome. The surgery for obesity has shown a marked difference in patients and in many cases the disease itself has been eradicated. The encouraging change in the patient’s lifestyle and positive output make doctors recommend it.”
It sounds promising as the intake is reduced and hence sugars reduce. But there have been reports of excessive insulin production causing low sugar levels after surgery. Although it is a rare phenomenon, experts state that it is still being studied and is not clearly understood why this happens in some cases.