Updated Surgical Management of Diabetes Mellitus

Abstract

Background: Diabetes mellitus is a major health problem as of 2014, an estimated 387 million people have diabetes worldwide. The number of people with diabetes is expected to rise to 592 million by 2035. Aim of the Work: The aim of this work to discuss the new trends in the surgical management of diabetes mellitus. Methodology: Diabetes mellitus is a devastating and complex metabolic disease, characterized by inadequate production or use of insulin, resulting in abnormally high blood glucose levels that leads to the formation of reactive advanced glycation end-products, which are responsible for complications such as blindness, kidney failure, cardiovascular disease, stroke, neuropathy and vascular dysfunction. Results: Diabetes mellitus is one of the top 10 leading causes of morbidity and mortality, affecting nearly 387 million people worldwide in 2014 and this value is predicted to rise to around 592 million by 2035. Conclusion: The basic design and objective of bariatric surgery is to reduce contact between food and the gut, either by reduction of intake, removal of part of the stomach, exclusion of segments of the foregut, or all of these. These effects of bariatric surgery are “dose related” to the diminution of the gut’s exposure to food: The adjustable gastric band (AGB) reduces the volume of food but does not change the surface area of the gut. The gastric sleeve (GS) removes the majority of the stomach, about 75 % of the total mucosal surface. The Roux-en-Y gastric bypass (RYGB) excludes almost all of the stomach plus the duodenum and about 150 cm of the small bowel. The biliopancreatic bypass with a duodenal switch (DS) is a gastric sleeve that also bypasses all but 100 cm of the small bowel. Keywords: Surgical Management, health problem, Diabetes Mellitus