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Dr. Ramen Goel

Bariatric Surgery: A Boon For Diabetes - 7th November 2017

Sweet News for >40 million Indian Diabetics

India will soon have dubious distinction of leading the world with maximum number of diabetics. It is believed that India had 50.8 million diabetics in 2010 which are likely to reach to 87 millions by 2030. These 6 crores Indians are leading a restricted lifestyle and are at high risk of heart attacks, vision loss, kidney failure, nerve damage, high BP & shortened life span.

Extensive research over 5 decades has resulted in identification of drugs & lifestyle modifications that results in good diabetes control. Despite these over 70% remain uncontrolled diabetics in India, primarily because of working hours, stress, poor eating habits etc. There is a need for a treatment that can provide steady blood sugar control despite these factors.

Metabolic surgery, started in 2004, is now accepted as a definite treatment for type 2 diabetes. Almost all patients are able to stop their insulin within 2-3 days of surgery &other medicines within 2-3 months.

International Diabetes Federation(IDF), American Diabetes Association(ADA) and American Association of Clinical Endocrinologists have accepted role of surgery for control of diabetes in overweigh/obese people. National Institute for Health & Care Excellence(NICE), UK has gone a step ahead to advise assessment for bariatric surgery even in newly diagnosed diabetic patients. Thus NHS of UK offers surgery to all citizens with diabetes. Employees of central government are eligible to benefit from bariatric surgery at CGHS approved hospitals. Even private insurance companies have started to accept claims of bariatric surgery with Star Health Insurance Company including it in their list of approved surgeries this year. This acceptance has come after over 40 years of research & analysis of surgical data.

According to Dr Ramen Goel, Director, Bariatric & Metabolic Surgery, Wockhardt Hospital, Mumbai ‘Blood sugar is controlled within 7 days – 90 days of surgery & remains so in majority of patients.’ Dr Ramen Goel is one of the dozen surgeons around the world conducting study on impact of surgery for normal weight diabetic patients. Results of metabolic surgeries have shown early control of blood sugar levels in almost all patients. ‘In most of the patients medicines are discontinued completely,’ he adds.

Control of diabetes is through mechanisms including secretion of hormones from last part of small intestine. All surgeries are performed through key-hole route or laparoscopically.

Most of the patients discontinue not only insulin but even tablets for diabetes treatment. Mr Pawar(name changed) from Bhiwandi  required insulin pump to control blood sugar & had lost vision due to diabetes. One year after surgery he is not only lighter by 40 kgs but is off any medicines for diabetes. His biggest remorse is that he had no information about this surgery before he lost his vision.

Certain blood tests can be done, in advance, to assess effectiveness of surgery in diabetes control. Results are better in patients with early diabetes & those not well controlled even by insulin,’ assures Dr Goel. ‘More patients from all over the world are travelling to india to get this surgery done & it a matter of time before most Indians realize effectiveness of this surgery, which is a boon for diabetics.’