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With 90 percent success rate Ileal Interposition surgery can treat severe type 2 Diabetes
Diabetes affects around 200 million people worldwide, and around three crore people in India. The incidence of Diabetes is expected to rise by 50 percent in the next ten years. Diabetes is not a single disease but a root cause of some major health problems. Presently, it is being treated by a few diet modifications, oral hypoglycemic medications and insulin therapy. But now there is a ray of hope for the non-obese type 2 diabetic patients in the form of Ileal interposition surgery.

This surgery, previously called transposition, is a new procedure that treats type 2 diabetes. The surgical technique is just six-year-old and was first tried in Goainia, Brazil. It was recently introduced in India after permission was granted by Indian Council of Medical Research (ICMR). There are very few centers which are authorized to perform such a surgery and the Gem Obesity and Diabetes Surgery Center is one among them.

Gem Hospital and Research Centre, in Coiambatore, is the only center in India with a specialized department comprising of the surgeon, lifestyle therapist, obesity coordinator and a dietitian under one roof. And Dr. Praveen Raj Consultant, Department of Obesity & Metabolic Surgery, is one of the team members in the hospital. He has been instrumental in create a revolution in finding a solution for the cure of type 2 diabetes, for which he has received international acclaim. This citizen journalist spoke with him about Ileal Interposition surgery.

CJ: What is 'leal interposition' surgery and how does it work?

Dr. Praveen Raj: Ileal Interposition surgery is a procedure by which a segment of the ileum (terminal part of the small intestine) is trans-located to the proximal end so that food gets entry to this part earlier than normal, and certain essential hormones (more specifically GLP 1) produced here rises in their level in the blood to have a beneficial effect on type 2 diabetes. This is done by means of reducing the insulin resistance and partly by increasing the secretion of insulin in the pancreas, which are the underlying problems in diabetes.

CJ: Can all the type-2 diabetes patients benefit from this surgery? If not, then what is the selection procedure?

Dr. Praveen Raj: Most patients will benefit, but it is not required unless the medical therapy is not effective. For example, certain patients will be given large doses of Insulin and tablets (oral hypoglycaemic agents) but still the sugar level in the blood will be way too high, and this is the category of patients which will require surgery. The surgery is not an alternative to medical therapy but the next stage in the management of diabetes.

CJ: Is there any age limit for the surgery?

Dr. Praveen Raj: There's no specific age limit as such. It all depends upon the fitness level to undergo surgery.

CJ: Are there any side-effects? How will it affect body weight?

Dr. Praveen Raj: There are no long term side effects except that the intake level and appetite of patients will be partially reduced.

CJ: Will the benefits of the surgery last life long?

Dr. Praveen Raj: It's difficult to say as these are relatively new procedures with data upto 5 yrs, showing 80-90% patients under control work out the need for medication.

CJ: What is the success rate of the surgery?

Dr. Praveen Raj: If done for the right set of patients more than 90% success rate is achievable. So we need the right patient and the right surgeon.

CJ: Is the surgery painful?

Dr. Praveen Raj: These are only laparoscopic operations hence the pain levels are not more than a appendicectomy.

CJ: How expensive is the surgery?

Dr. Praveen Raj: It depends. It may vary between 2.5 - 3 lakhs depending upon the center and the surgeon.

CJ: What's the recovery time needed by the patient after the surgery?

Dr. Praveen Raj: The recovery is usually short. The hospital stay is between 3-4 days max and may be a couple of more days at home before they could join work again.

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