FOLLOW-UP AFTER DIABETES SURGERY

All patients undergoing Metabolic Surgery should be under the joint follow-up by the surgery and endocrinology departments after the operation. It should always be kept in mind that the recovery process of diabetes may be variable and that there is a risk of relapse of the desease.

Higher blood sugar level occured due to surgical stress should be kept under control by injecting insulin if necessary.

In a significant number of patients, the need for medication-insulin decreases or disappears within the first few days or a few weeks after the operation. Regardless of the patients weight loss, it is due to the surgery calorie restriction effect resulting from minimized food and drinks intake.

As a result of the effects the hormones (incretins) released from the intestines have, blood sugar levels are found to be completely controlled at most of the patients in about one month later. In some resistant cases this period may extend up to 3 months, thus considerably to this postoperative check-ups should be performed.

Tissues insulin sensitivity gets increased due to the patients-weight loss. The blood sugar regulating effect provided by this process could be significantly noticed up to 6 months after the operation when significant weight loss is about to be achieved.

For achieving long-term regulation, it is estimated that the levels of glycosylated hemoglobin (HbA1c) should be kept below 6% average.

Eventhough many patients have high success rates of improvment in the first two years, there are studies based on long-term postoperative follow-up showing that there is still a risk of recurrence of diabetes. It is observed that diabetes may relapse in case of re-gaining weight. At this point, there are some arguments reffering to metabolic surgery postponing for years instead of treating diabetes in time.

The results of more than ten years of diabetes follow-up studies published in the medical literature are still insufficient. However, as diabetes is seen as a progressive disease with implicated complications that can destroy many organs and systems, the tendency for surgical treatment is increasing, especially at patients having difficulty in achieving blood glucose level control with standard medication-insulin therapies.