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Diabetes Surgery

Introduction

Diabetes is a chronic disease that occurs when the pancreas is no longer able to make insulin, or when the body cannot make good use of the insulin it produces. Insulin is a hormone made by the pancreas, that acts like a key to let glucose from the food we eat pass from the blood stream into the cells in the body to produce energy. All carbohydrate foods are broken down into glucose in the blood. Insulin helps glucose get into the cells. Not being able to produce insulin or use it effectively leads to raised glucose levels in the blood (known as hyperglycaemia). Over the long-term high glucose levels are associated with damage to the body and failure of various organs and tissues.

Types of Diabetes

Type 1 diabetes- can develop at any age, but occurs most frequently in children and adolescents. When you have type 1 diabetes, your body produces very little or no insulin, which means that you need daily insulin injections to maintain blood glucose levels under control
Type 2 diabetes- It is more common in adults and accounts for around 90% of all diabetes cases. When you have type 2 diabetes, your body does not make good use of the insulin that it produces. The cornerstone of type 2 diabetes treatment is healthy lifestyle, including increased physical activity and healthy diet. However, over time most people with type 2 diabetes will require oral drugs and/or insulin to keep their blood glucose levels under control
Gestational diabetes (GDM)- It is a type of diabetes that consists of high blood glucose during pregnancy and is associated with complications to both mother and child. GDM usually disappears after pregnancy but women affected and their children are at increased risk of developing type 2 diabetes later in life.

Risk Factors

Risk factors include:

  • A variety of risk factors for the development of diabetic neuropathy are known (Table 3). According to the Diabetes Control and Complications Trial,1 hyperglycemia is one of the most significant risk factors. Others include a long duration of diabetes, large total exposure to hyperglycemia, male sex, advanced age, elevated lipid levels, elevated blood pressure, kidney disease, cigarette smoking, overweight, increased height, and a high level of exposure to other potentially neurotoxic agents, such as ethanol. Genetic factors, such as the HLA-DR3/4 phenotype and apolipoprotein E genotype, are also associated with a risk for diabetic peripheral neuropathy.

Procedure

Procedure include:

  • Metformin Metformin is believed to be the most widely prescribed anti-diabetic drug in the world. It is the first-line drug of choice for the treatment of type 2 diabetes, particularly in overweight people and those with normal kidney function.
  • Insulin injection-Insulin injections have saved millions of lives. Diabetics often need to inject themselves with insulin several times a day, as well as taking regular blood sugar level checks. The inconvenient and cumbersome nature of this has led to searches for new ways of delivering insulin to the body. Currently, the only main alternative to injections is an insulin pump, but there are several different approaches that are being developed. Insulin pumps slowly infuse insulin into the body and are good for patients who have trouble controlling their glucose levels. The small pumping device, worn outside the body was invented at Guy's Hospital in London and was based on the miniature infusion pump developed for infusing parathyroid hormone into dogs and other animals.
  • Islet transplants- Insulin is normally produced by islet or beta cells in the pancreas. Currently, islet transplantation is the only curative therapy for late-stage type 1 diabetes. Successfully carried out in rats, dogs, monkeys and humans, this treatment requires the patient to take immune-suppressants to prevent rejection. Clinical islet transplantation is also restricted by a severe shortage of donor islets. The video on the right features Dr Aileen King discussing some of her research to improve this process.

Range of Treatment Cost

Procedure Min Cost (INR) Max Cost (INR)
Type 1 diabetes 27000₹ Per year 40000₹ Per year
Type 2 diabetes 150000₹ 350000₹
gestational diabetes 50000₹ 200000₹
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