Diabetes is now also treated in the operating room.Time surgery can cure or improve up to 95 percent of type 2 patients.
Alfredo is always remembered fat.Always on a diet and always without results.Over the years, he developed a type 2 diabetes, the variant of this pathology that is related to excess weight.His life, together with his 128 kilos, was increasingly complicated.Until he operated at 72 and left the disease behind.He came out of periodic insulin injections free surgery and with a better quality of life.Alfredo is one of the patients who has forgotten his diabetes.
Type 2 diabetes no longer suffers, but 13.8% of the Spanish population still suffers from it, according to a study prepared by the Biomedical Research Center in the Associated Metabolic Diseases and Metabolic Diseases (CIBERDEM).Type 2 diabetes is «a metabolism disorder caused by a malfunction of insulin (the hormone that secretes the pancreas to process blood sugar), explains Clotilde Vázquez, head of the endocrinology and nutrition service of the Jiménez Díaz Foundation (FJD), Clotilde Vázquez at a breakfast organized by the ABC newspaper with specialized doctors.
Unlike type 1 diabetes, there is no insulin deficit but that a set of changes causes not to act correctly ».Diabetes damages all organs of our body (heart, kidney, eyes, pancreas ...) and is cause of death.It is calculated, according to the World Health Organization (WHO), which in 2012 died 1.5 million people as a direct consequence of this pathology.
Sedentary population
«There is no comorbidity,” the head of the Endocrinology and Nutrition Service of the Quirón Health University Hospital in Madrid, Esteban Jódar, linked to being obese as diabetes.The western world is dying of success.The most violent exercise we do is run to grab the elevator and that can only lead to an obesity that in turn leads to diabetes ».Despite this, not all obesity necessarily leads to the development of diabetes, even if a great genetic component is present."We have-Indica Esteban Jódar- people not obese and metabolically ill."
Start before
What is certain is that the treatment can begin even before the disease appears, which is known as prediabetes.An elevation in normal blood glucose levels that, if not, can cause the development of pathology.Treatment that would begin by modifying the patient's lifestyle, that is, its diet and exercise routine.«It is the most effective measure-explains Esteban Jódar- and the one that achieves more long-term results, even after ceasing the intervention.But also the most expensive, since it demands regular interviews with a dietitian and someone who plan an exercise program ».
And it is not just a matter of individual responsibility.As Clotilde Vázquez, the Administration, seeks, looking for the public good, has to support health measures such as increasing the number of physical education hours in schools.
Once the patient has been diagnosed as a diabetic, different treatment alternatives are presented, apart from changing their lifestyle, such as the use of drugs or undergoing surgery.And this does not have to be the last option when everything else fails."It can be the first," says Clotilde Vázquez, "if, seeing the entire trajectory of the person, it is decided that it is the most appropriate way.
It is generally worth it, even as a preparation for surgery, remove all possible insulin, modify life habits and administer drugs that imitate metabolic surgery.In some cases, giving these treatments, it is not necessary to reach the operation ».
Failure of thewillpower?
Submit to surgical operation should not be understood as a failure in the will of the obese patient.This is indicated by the director of the Laparoscopic Center Dr. Ballesta of the Ruber International Hospital and pioneer in the use of surgery capable of healing diabetes, Carlos Ballesta: «I do not think it is fair to criminalize the obese, society already does.It is a non -controllable hormonal problem ».A problem that surgery is able to fix.
Diabetes surgery, better known as metabolic surgery or "surgery that operates hormones" revolves around the pancreas, the organ that produces insulin.«In the stomach, duodenum and small intestine Carlos Ballesta- of a person, as of food (and only when they pass), there are a series of hormones that order the pancreas to secrear insulin to metabolize the blood sugar.
The pancreas of the type 2 diabetic is sick and is unable to respond to so much order at the same time so the insulin it produces is insufficient and diabetes appears ».To put an end to this, metabolic surgery performs a metabolic By-Pass through which foods pass directly from the stomach to the distal part of the intestine.In this way, «the hormones that occur in the duodenum and first part of the intestine are blocked.In doing so, we download orders to the pancreas and it responds by segregating the insulin necessary to cure diabetes ».
High at 48 hours
Alfredo immediately felt the results of the surgical intervention.«I got out of operation as a new man-remember.I have a year longer than when I operated but 20 less as a quality of life ».
The patient is discharged at 48 or 72 hours of performing surgery.«Days or weeks later- Carlos Ballesta affirms- the patient ceases to be diabetic, he does not need to apply insulin, the diseases that produce in eyes (retinopathy), heart (angiopathy, infarction) are not».In turn, according to the specialist, "the healing indices with this surgery vary between 75% at 6 months of the operation, up to 85% at two years, reaching 97% improvement figures."
Stable metabolically
However, the operation is not exempt from problems and limitations.To begin with and according to the specialist in endocrinology and nutrition, Alberto Aliaga, "not all endocrine are clear that this surgery can be a good treatment."In turn, surgery will be less effective according to age and time of evolution of patient's disease.
Without forgetting the importance of your attitude."That patient-says Alberto Aliaga- who wants to operate without considering that you may need medications or cultivate new life habits, probably fail."Taking this into account, Dr. Carlos Ballesta asserts that “the important thing with surgery is to spend half an hour with the patient and explain the advantages and disadvantages, the risks ... the patient has to know everything because it is the most important decision of hislife.If you get it well informed, the patient will go well ».
But he will keep the scars of his illness."Diabetes lesions," explains the service manager of the Laparoscopic Surgery Unit at the Zaragoza Health Hospital, Jorge Solano- we can stabilize them, never retrograde them. "In turn, as Jorge Solano indicates, the patient, although fattening, is metabolically stabilized and can eat foods rich in sugars, always in moderation.As Dr. Carlos Ballesta is in charge of remembering, the risk of relapse exists: "The patient should always keep the mental concept of which it is diabetic."
Type 2 diabetes is no longer just an adult disease.Every time it is diagnosed before.The cases of young patients with diabetes ceased to be anecdotal in the last fifteen years."Children over twelve-years-Clotilde Vázquez-emphasize to develop prediabetic or diabetic syndromes and also with resistance to treatment greater than in adults."Another added problem is that the main risk factor for the development of the disease is obesity, one of the pandemics of the 21st century.
