SURGERY FOR TYPE 2 DIABETES MANAGEMENT
Type 2 Diabetes is most often associated with being overweight.
Weight loss surgery procedures have been shown to help with better control of Type 2 Diabetes, and in randomised trials, surgery has shown to give better results than the best non-surgical medical treatment with regards to blood glucose control and reduction in diabetes medications.
Other conditions that are often present with Type 2 Diabetes and being overweight include high blood pressure, raised cholesterol, obstructive sleep apnoea (patients that snore loudly and therefore do not take in enough oxygen while they sleep leading to excessive daytime tiredness and foot and ankle swelling). All of these conditions are potentially improved after bariatric surgery.
There is good evidence showing the complications of Diabetes such as kidney damage, eye, nerve and feet problems are also improved after a bariatric surgery procedure.
Is WEIGHT LOSS SURGERY FOR DIABETES RIGHT FOR ME?
Professor Purkayastha explains how weight loss surgery can be beneficial for people with Diabetes, and when might be the best time to consider a surgical intervention.
DO I QUALIFY FOR BARIATRIC SURGERY?
NICE (National Institute for Health & Care Excellence) guidance states that patients with a BMI of 35 or more with an associated comorbidity (e.g. high blood pressure or OSA), qualify for surgery. If patients have a BMI of 40 or more then they qualify as well.
Patients with Type 2 Diabetes, qualify for bariatric surgery with a BMI of 30 or more. Patients from Asia qualify for bariatric surgery at a BMI of 2.5 less than non Asians, due to their increased risks of harm from being overweight and the associated co-morbidities.
LET US EXPLAIN HOW WE CAN HELP YOU
Speak with our friendly patient concierge team, and let us answer any questions you have about weight loss surgery.
SURGERY FOR TYPE 1 DIABETES MANAGEMENT
Some patients with Type 1 Diabetes who have been on insulin injections for many years, struggle with absorption of insulin and consequently prolonged periods of raised blood glucose levels, despite being on high doses of insulin.
These same patients can also experience a complete switch in this problem, suddenly absorbing too much insulin, resulting in very low blood glucose levels, and experiencing dizziness, feeling unwell and even collapsing.
For these patients one potential solution is the use of a Diaport Catheter. This device, which is surgically implanted, allows insulin to be infused directly into the peritoneal cavity (inside the abdomen) where insulin absorption is better, thus alleviating the problems described above.
Professor Purkayastha is an experienced surgeon in the Diaport Catheter Insertion procedure in London.
Dr Saira Hammed is an Endocrinologist and Diabetes Specialist, and will work closely with your surgeon and dietitian to support you in achieving best outcomes from your weight loss surgery for Diabetes.
SOME IMPORTANT INFORMATION ABOUT SURGERY FOR DIABETES
Here are some questions about surgery for diabetes we are frequently asked by patients. We believe it is important you have all the information you require, so you can make an informed decision if surgery is the right option for you.
If you have a BMI of 35 or above and diagnosed Type 2 diabetes, surgery can be an effective way to lose weight and improve your health. There are different surgery options, and Mr Purkastha can talk you through how each surgery works, and which would be the best option for you.
The surgeries we offer are listed below, with the average weight loss achieved for each surgery
Gastric Sleeve – up to 75% of excess body loss in the first year after surgery
Gastric Bypass – up to 80% of excess weight loss in the first 18 months after surgery
Mini Gastric Bypass – up to 35% of excess weight loss in the first year after surgery
Gastric Band – up to 50% excess weight loss in first year after surgery Gastric Balloon – non-surgical and temporary option which can help individuals lose up to 20kgs of excess weight whilst fitted
Bariatric surgery can often put type 2 diabetes into remission. By reducing the size of the stomach, your food/calorie intake is reduced and sustainable weight loss is achieved over time. Bariatric surgery doesn’t just work by reducing the size of the stomach. It can impact the functioning of hormones in your digestive system that control insulin production and lead to lower blood sugar levels.
Surgery is the most effective option when coupled with healthy diet and lifestyle changes.
The other positive health outcomes from bariatric surgery include significant weight loss and the reduction of conditions related to increased weight. This includes but not limited to:
- High Cholesterol
- High Blood Pressure
- Heart Disease
- Mobility issues
- Joint pains
- Sleep Apnoea
Weight loss and better health can also improve the quality of your life and mental health, boosting self confidence and opening up new doors for how you want to live your life
Professor Puraksyastha will walk you through the preparation steps in the weeks leading up to your surgery. The support you are given is tailored to you, following full metabolic, dietetic and psychological assessments. This is to ensure the best preparation and outcomes possible.
Our specialist dietitian will help you to prepare for your surgery by undergoing a pre-operative liver-reduction diet lasting two weeks. The diet is low in fat and moderate in protein and low in calories, providing approximately 800-1000 kcal per day. The aim of the pre-operative diet is to shrink your liver meaning it can be moved more easily, making the operation safer. In the 24 hours before your surgery, you will be required to restrict your food and drink intake.
Our specialist psychotherapists will also help you to be best prepared for your surgery, ensuring you have the psychological support to ensure best outcomes.
Diet and lifestyle changes are the same irregardless of which surgery option you choose. The Surgical WeightMatters team will be with every step of the way to support you in making these changes and enjoying your healthier lifestyle.
There are three stages of texture modification diet following surgery, starting with a liquid diet and gradually building this back up to a long term, solid textured food.
Your specialist dietitian will help explain and guide your through the post-operative diet which follows the below stages:
- liquid diet (10 days)
- puree diet (3-4 weeks)
- soft diet (for around 6 weeks)
This is followed by a lifelong healthy, high protein diet of a normal solid texture from 12 weeks onwards.
Fluid intake remains important and you should aim to drink 1.5 litres a day. Avoid high calorie fluids including hot drinks made with sugar and fizzy drinks as these can cause bloating and discomfort.
Alcohol should not be taken for three months after surgery and after this time in moderation after food.
Exercise – After surgery we advise you to move around as much as possible and ensure that you don’t get dehydrated. Exercise should be gentle for the two months – i.e. swimming, walking, cycling. No heavy lifting or weight training for at least eight weeks
In the long-term increased activity levels are needed alongside a reduced dietary intake for optimal and sustained weight loss after bariatric surgery.
Driving – You should not drive for the first two weeks following surgery and contact your insurance to find out what their guidelines are.
We suggest that when you are ready to drive that you ask a family member or a friend to drive you to a quiet street where you can attempt an emergency stop. If it feels comfortable then it is fine for you to drive.
Travel – We advise that you do not take a long haul flights for 8 weeks following your surgery
You can take flights of no more than 2 hours duration from two weeks after your surgery
Pregnancy – We advise you to avoid pregnancy for 2 years after surgery. Oral contraception can be restarted 1 month after surgery
Smoking – It is strongly advised to quit smoking in the long-term as this can undo the positive health outcomes from surgery, and increases risk of ulceration in the gastric pouch, chest infections, cancers and heart disease.
After your recovery period has ended, you can start to enjoy the lifestyle changes that come about from better health and increased mobility associated with bariatric surgery.
Your aftercare package includes prolonged support from Mr. Purkayastha and your specialist dietitian, as well as the wider Surgical WeightMatters team.
You will have in-person follow-up appointments with Mr. Purkayastha arranged 7-10 days, 3 months, 6 months and 12 months after surgery with the option of additional follow-up appointments to check in with your progress.
You will have several post-operative appointments with your specialist dietitian as well, which are spread over 2 years after your surgery and tailored to suit your needs.
There is no limit to how many sessions you can have with the Surgical WeightMatters team. We are with you every step of the way to ensure the best support and outcomes possible.
My Purkayastrha will take time to talk you through the risks involved with each surgery option and ensure you are fully informed before deciding which option you wish to have.
Every effort ensures these risks are avoided, and Mr Purkayastha is an extremely experienced bariatric surgeon. However, the short and long-term risks involved with bariatric surgery are as follows:
- Infection of the wound
- Adverse reactions to anaesthesia
- Blood clots
- Breathing problems
- Leaks from the cut edge of the stomach
- Potential complications from nutritional deficiencies
- Dumping syndrome
- Gastrointestinal obstruction
- Gastroesophageal reflux
- Low blood sugar (hypoglycemia)
- Malnutrition, food intolerances or Dumping Syndrome
- Blood clotting
- Stomach ulcers
- Barrett’s oesophagus
Weight regain, if diet and lifestyle changes are adhered to lifelong habits
Complications during surgery can result in elective or emergency medical or surgical (reoperation) treatment.
If you are interested in Surgery For Diabetes and still have some questions, please book a complimentary call with our friendly Patient Concierge team.
They will listen to your story, answer your questions, and ask about your health goals. If you are ready, they will get you booked in to meet your surgeon for a pre-surgery metabolic assessment and consultation.
HOW MUCH DOES SURGERY FOR DIABETES COST?
We believe it is important to be upfront and transparent about the costs of the various bariatric surgeries we provide.
Click on the links to find out the cost of each surgery and our complete 2-year aftercare package.
We recommend booking in an initial Metabolic Assessment to discuss your bespoke requirements and how weight loss surgery can support your long-term management of Diabetes.
- Review of your weight history
- Assessment of your current health picture
- Explore your motivation and goals
- Understanding your readiness and support structure
- Bespoke treatment pathway designed for you
- Build trust with your surgeon and care team