A new laparoscopic method that preempts "displacement" of the small bowel (called ideal interposition surgery) has succeeded in bringing patients with type 2 diabetes into remission in 90% of cases. After the intervention, they do not need insulin and oral pills to control their diabetes. They also do not have to take medications for cholesterol and high blood pressure that often accompany diabetes. So far, the new method, which requires a very high level of professionalism, is being applied by only a dozen surgeons in a few medical facilities in the world - in Brazil, Japan, India, America, Italy and Turkey. One of these specialists is Dr. Turil Demirel of the Medical Park Gaziyosmanpasha Hospital in Istanbul, who talks about the promised new method.
The operation is suitable for patients with the much more common type 2 diabetes who have a preserved insulin reserve in the pancreas and are aged 18-65 years. It usually lasts between 3 ½ and 6 hours, and patients recover in 5 to 6 days and start eating normally. This type of surgery is different from the bariatric ( also called metabolic ) surgery methods commonly used in obese and diabetic patients. In contrast, ideal interposition surgery can also be used in patients with type 2 diabetes who are not overweight and does not result in malabsorption, i.e., failure to absorb nutrients.
So far, Dr. Turul Demirel has applied the new method in 41 patients with severe type 2 diabetes. Previously, they had lived with the diagnosis for 3 to 30 years. All had poor blood sugar control and high insulin requirements, and many had organ dysfunction. After surgery, 36 of the patients went into complete remission, i.e. they came off their oral antidiabetics and insulin and continued to eat normally . In one of the operated patients there was no improvement, while in the others the intake of medications decreased significantly and the quality of life increased.
"The results so far show that with the ideal interposition surgery we are able to beat diabetes in 90% of the cases and I think we can rate this as a good achievement," says the surgeon. He said the effect of the surgery depends on many factors, including the duration of the disease, comorbid chronic diseases , a number of family and genetic factors. The earlier a patient has surgery, the better the chances of success, because the insulin reserve in the pancreas can diminish or become depleted with each passing year. Diabetes usually worsens over time, and long-term complications include cardiovascular problems, blindness, neurological problems and kidney damage. Therefore, modern medicine is looking for treatment methods to achieve a permanent solution to the problem.
