What is Diabetes?

Diabetes mellitus in adults is the gradual decrease of the insulin hormone made in the pancreas over time or the ineffectiveness of the produced insulin. Diabetes is a lifelong disease that progresses silently and reaches epidemic proportions all over the world.

Although there is basically high blood sugar in diabetes, it is often seen that there is fat in the blood, high in bad cholesterol, low in good cholesterol, and fatty liver. It is thought that the number of people with diabetes, which was 171 million in the 2000s, will reach 366 million in the 2030s. The increase in life expectancy, decrease in physical activity and increase in obesity have led to a rapid increase in diabetes. 80-90% of diabetic patients are obese.

According to the study named TURDEP-II, published in November 2010 in Turkey, the prevalence of diabetes increased by 90%, from 7.7% to 13.7%, while obesity rates increased by 44%. Due to the damage done by diabetes in the organs, health expenses increase seriously and bring a great socio-economic burden to the societies.

Diabetes Treatment

Although diabetes has been known since ancient times, the possibility of treatment began after the discovery of insulin. Treatment possibilities have expanded with the discovery of oral drugs. Increasing understanding of the mechanism of diabetes has helped to find new drugs. The main purpose of diabetes treatment is to prevent vital organ damage.

Regardless of the treatment, diet and exercise are the rules that must be followed. In addition, various drug combinations are applied. The treatment to be chosen for each diabetes patient is specific depending on many factors. Today, despite all kinds of treatment possibilities, it is not easy to regulate blood sugar level.

Each treatment has its own benefits and side effects. Today, there is no cure for diabetes, and it is impossible to say otherwise, according to current scientific standards. However, the blood sugar level can be reduced to a level close to normal, this does not mean that diabetes is gone. There are effective treatments and alternative methods that can be adjusted for each patient.

While evaluating the treatment possibilities according to the patient, many aspects of the patients should be evaluated. The patient’s age, organ complications, level of adaptation to treatment, socio-economic status, sustainability, long-term results of the treatment… should be examined. The main goal is to maintain blood sugar levels as close to normal as possible.

In diabetic patients, the level of sugar (glucose) in the blood rises depending on the calories taken, that is, the type and amount of food. The main hormone involved in lowering glucose is insulin. Insulin allows glucose to enter the cell.

The main axis in all treatments is to help insulin secrete adequately, effectively and regularly. Sometimes this is to increase the production and secretion of insulin in the pancreas, sometimes to ensure the effectiveness of insulin at the cellular level, and sometimes to eliminate the causes that require excessive insulin production.

While lowering glucose in diabetic patients, it is necessary to treat the reasons that hinder this and complicate the treatment, otherwise the treatment will fail. As an example of these; lowering high fat level, bad cholesterol, balancing blood pressure, preventing obesity.

In recent years, it has been understood that the digestive system plays an important role in the formation of diabetes. Some of the hormones secreted in the intestines, including incretin or GLP-I, are used as drugs in the treatment of diabetes today, and it is an important treatment option.

One of the most important problems of diabetes patients is weight gain during treatment, excessive eating cravings, and accordingly the increase in the number and doses of drugs. Insulin is one of the most classic examples of this. Keeping the weight and glucose in balance is the main problem.

The struggle of keeping glucose in balance with obesity has led to the search for alternative ways in the treatment of diabetes.

With this in mind, various surgical treatment methods have been developed that can control diabetes along with obesity, especially in severely obese patients. Today, these surgical treatment methods are applied successfully. Surgical treatment of diabetes has been included in the treatment options by international associations and committees. The IDF (International Diabetes Federation) recommends surgical treatment for patients with a body mass index (BMI) >30 kg/m2 and who cannot be controlled by insulin and other treatments.

It was known that there were significant decreases in sugar levels, especially as a result of the weight loss of obese patients with surgical treatment.

In recent years, it has been understood that many hormones secreted in the digestive system, especially in the intestines, have an effect on the balance of sugar. The most important of these, glucogon-like peptide-I (GLP-I), which is used as a medicine today, is made more effective by various surgical methods and lowers blood sugar. It is also called metabolic surgery by some teams.