Diabetes Surgery (Metabolic Surgery): A Life-Changing Approach Against Type 2 Diabetes!

Type 2 diabetes is a chronic disease that affects millions of people worldwide, reduces quality of life, and can lead to serious complications. While drug treatments, insulin use, and lifestyle changes play an important role in controlling the disease, these methods may be insufficient for some patients, or achieving blood sugar targets can be challenging. At this point, diabetes surgery (metabolic surgery) is an advanced surgical approach that offers revolutionary results in the treatment of type 2 diabetes, especially when it coexists with obesity. These operations not only ensure weight loss but also positively affect intestinal hormones and insulin resistance through changes made in the digestive system, providing a dramatic improvement in blood sugar control, or even complete remission. Estebox Istanbul, with Turkey’s pioneering role in metabolic surgery and multidisciplinary expert staff, offers you special and comprehensive support to open a brand new page for your health and quality of life with diabetes surgery.

What is Diabetes Surgery? Just Weight Loss, or Reprogramming Metabolism?

Diabetes surgery refers to special surgical procedures based on the principles of obesity surgery (bariatric surgery) but with the primary goal of controlling or eliminating type 2 diabetes. These surgeries work by reducing stomach volume and, more importantly, by altering the food passage route of specific parts of the small intestine (bypassing or transposing them). As a result of these changes:

• Changes in Intestinal Hormones: The levels of “good” hormones like GLP-1, which are secreted from the lower parts of the small intestine and increase insulin secretion and reduce insulin resistance, increase. At the same time, the effect of “bad” hormones that contribute to insulin resistance decreases.
• Increased Insulin Sensitivity: The body’s sensitivity to its own insulin increases, allowing blood sugar to be taken into cells more effectively.
• Reduced Pancreatic Load: Thanks to weight loss and increased insulin sensitivity, the pancreas’s burden of overproducing insulin decreases, which can help protect the beta cells of the pancreas.
• Weight Loss: Significant weight loss is achieved with the reduction of stomach volume and/or decreased absorption, which positively affects diabetes control.

Diabetes surgery not only lowers blood sugar but can also contribute to the improvement of other metabolic problems associated with diabetes, such as hypertension, high cholesterol, and fatty liver disease.

Could Diabetes Surgery Be a Hope for You? Who Are Candidates for This Advanced Treatment?

Diabetes surgery is not suitable for every type 2 diabetes patient. These operations are generally considered for patients who meet the following criteria and whose blood sugar control cannot be achieved with other treatment methods:

• Individuals with a Body Mass Index (BMI) of 35 kg/m² or higher and uncontrolled type 2 diabetes.
• Type 2 diabetes patients with a BMI between 30-34.9 kg/m² whose blood sugar targets cannot be reached despite drug treatments and lifestyle changes (HbA1c value usually 7.5% and above) (according to international diabetes and obesity surgery guidelines, with doctor’s decision).
• Patients who still have a sufficient amount of insulin reserve in their pancreas (evaluated by C-peptide levels). (Not suitable for Type 1 diabetes patients, as the problem in Type 1 diabetes is the lack of insulin production).
• Individuals who are ready and motivated to accept the risks, benefits, and lifelong lifestyle changes (nutrition, vitamin supplementation, regular follow-up) of the surgery.
• Those whose general health condition is suitable for a laparoscopic surgery and general anesthesia.

The decision for diabetes surgery should be made jointly with the patient after a very detailed evaluation by a multidisciplinary team consisting of an endocrinologist, bariatric/metabolic surgeon, dietitian, and psychologist.

Main Methods Applied in Diabetes Surgery: Techniques Differentiating Metabolic Effects

There are many different techniques applied for diabetes surgery. The common goal of these techniques is to create strong metabolic effects, especially on diabetes, in addition to weight loss. Some important techniques are:

1. Gastric Bypass (Especially Roux-en-Y Gastric Bypass – RYGB): Highly effective on type 2 diabetes with both its restrictive and malabsorptive effects. (You can find details on our “Gastric Bypass” page).
2. Duodenal Switch (DS) and Its Modifications (e.g., SADI-S – Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy): These operations involve stomach reduction (usually in the form of a sleeve gastrectomy) along with bypassing a much longer section of the small intestine. They provide very strong weight loss and diabetes improvement, but the risk of malabsorption and vitamin-mineral deficiency is higher, so they should be applied in very selected patients and experienced centers. SADI-S is a more current and potentially safer modification of Duodenal Switch.
3. Ileal Interposition: In this technique, the last part of the small intestine (ileum) is cut and moved higher up, either to the stomach outlet or the beginning of the duodenum. The aim is to ensure earlier contact of “good” hormones like GLP-1 with food, thereby increasing insulin secretion and sensitivity. It may be preferred for patients with lower BMI but uncontrolled diabetes.
4. Transit Bipartition: In addition to sleeve gastrectomy, the last part of the small intestine is connected to the stomach outlet as a second pathway. Some of the food passes through the natural route, and some through this new route. Both weight loss and strong diabetes control are targeted.

Your surgeon will determine the most appropriate surgical technique for you based on your metabolic condition, pancreatic reserve, BMI, and other health factors. All these operations are usually performed laparoscopically (closed method).

Your Diabetes Surgery Operation: The Path to Metabolic Renewal

Diabetes surgery is a complex operation that requires a high level of expertise and multidisciplinary teamwork:

• Comprehensive Preparation and Multidisciplinary Evaluation: Very detailed blood tests (especially hormone and vitamin levels, C-peptide), endoscopy, cardiological evaluation, respiratory tests, and many other examinations are performed before the operation. Suitability for surgery is meticulously evaluated by a team consisting of an endocrinologist, surgeon, dietitian, and psychologist.
• Anesthesia and Laparoscopic Surgery: The surgery is performed under general anesthesia. Necessary adjustments are made in the stomach and intestines according to the selected metabolic surgery technique by entering through small incisions made in the abdominal wall.
• Operation Duration: It can usually last between 2 to 5 hours, depending on the complexity of the technique to be applied.

After Diabetes Surgery: A New Life, New Responsibilities

Life after diabetes surgery brings both great hope and significant responsibilities:

• Close Follow-up in Hospital: You will usually need to stay in the hospital for 3-7 days after the operation. During this period, your blood sugar levels, fluid-electrolyte balance, and possible complications are closely monitored.
• Nutrition “Metabolic Adaptation”: Post-operative nutrition, similar to gastric bypass, should be gradual (liquid, puree, soft solid, normal solid) and planned very strictly by a bariatric dietitian. Portion control, eating slowly, chewing well, and especially protein intake are vital.
• Adjustment of Medications: A rapid drop in your blood sugar levels may be seen after surgery. Your diabetes medications and insulin doses may need to be readjusted or completely discontinued by your doctor. This must be done under strict doctor supervision.
• Lifelong Vitamin and Mineral Supplementation: Especially after procedures with malabsorptive effects (gastric bypass, SADI-S, etc.), the risk of deficiency of many vitamins and minerals (B12, iron, calcium, D vitamin, fat-soluble vitamins, etc.) is high. It is absolutely necessary to use these supplements regularly for life and under doctor supervision. Otherwise, serious health problems may arise.
• Regular Exercise and Lifestyle: Regular physical activity is an integral part of your new lifestyle to support weight loss, maintain muscle mass, increase insulin sensitivity, and improve overall health.
• Lifelong Multidisciplinary Follow-up: The success after diabetes surgery is not limited to the surgery alone. Lifelong regular follow-up appointments with your surgeon, endocrinologist, dietitian, and, if necessary, psychologist are vital for monitoring your health status, updating your nutritional and supplementation needs, and ensuring the permanence of the achieved success.

Diabetes Remission Rates: With diabetes surgery, partial or complete remission rates for type 2 diabetes are reported to be between 60% to 90%, depending on the surgical technique applied, the patient’s pre-operative duration of diabetes, pancreatic reserve, and adherence to post-operative lifestyle changes.

Why Turkey for Diabetes Surgery? Reinvest in Your Health with Estebox Istanbul

Turkey has world-renowned, pioneering, and experienced surgeons in highly specialized and advanced surgical operations like diabetes surgery (metabolic surgery), and multidisciplinary centers of excellence that operate in accordance with international guidelines. Istanbul stands out with healthcare institutions that offer the highest standards in the surgical treatment of type 2 diabetes, prioritizing patient safety, ethical values, comprehensive multidisciplinary care, and long-term follow-up.

As Estebox Istanbul, we offer you comprehensive, reliable, and personalized consultancy and support services during your diabetes surgery process, one of the most effective and potentially life-changing solutions in your fight against type 2 diabetes. We work with internationally recognized bariatric and metabolic surgeons with deep experience and proven success in diabetes surgery, JCI-accredited, fully equipped hospitals with all necessary infrastructure for such complex operations, and a team of expert endocrinologists, dietitians, psychologists, and other healthcare professionals who will manage your pre-operative preparation and post-operative long-term recovery process. From detailed pre-operative medical evaluation and suitability analysis, your travel, accommodation, and hospital arrangements in Turkey, to long-term post-operative multidisciplinary follow-up and consultation services, we are with you every step of the way. Our goal is not only to ensure you achieve successful diabetes control and weight loss but also to help you improve your overall health and step into a brand new, energetic, and high-quality life.

Diabetes Surgery Prices in Istanbul: The Most Important Investment in Your Health and Future

The cost of diabetes surgery operations varies depending on many important factors such as the specific surgical technique to be applied (RYGB, SADI-S, Ileal Interposition, etc.), the complexity of the operation, the experience and expertise of the surgeon and multidisciplinary team, the technological infrastructure and comprehensive service quality of the hospital where the surgery will be performed, the length of hospital stay, the quality of special laparoscopic materials and staplers used, and the scope of intensive multidisciplinary follow-up and consultation services offered before and after the surgery. This can generally be a more comprehensive and therefore more costly process compared to other bariatric surgery operations.

However, diabetes surgery prices in Turkey are generally more competitive and accessible compared to similar quality highly specialized and comprehensive healthcare services in many Western countries. This means you can access this important operation, which can radically change your life and health, with a more affordable budget without compromising on quality, safety, expertise, and multidisciplinary care. Estebox Istanbul organizes a detailed pre-assessment and expert doctor consultation to offer you a treatment plan tailored to your specific medical condition, diabetes characteristics, and expectations, and transparent pricing accordingly. Please do not hesitate to contact us to get clear information about the cost of your diabetes surgery operation and to benefit from our free consultation service.

What You Need to Know About Diabetes Surgery: Frequently Asked Questions (FAQ)

Q: Does diabetes surgery also treat Type 1 diabetes?

A: No, diabetes surgery is primarily aimed at treating Type 2 diabetes. Type 1 diabetes is an autoimmune disease in which the pancreas cannot produce enough insulin, and its treatment is insulin replacement. Since diabetes surgery is based on the principles of breaking insulin resistance and increasing insulin secretion, it is not effective in Type 1 diabetes.

Q: Can I completely stop my diabetes medications after surgery?

A: Many patients experience a significant improvement in blood sugar control after diabetes surgery and can reduce or completely stop their diabetes medications. Full remission (drug-free normal blood sugar) rates are high, but this depends on the patient’s pre-operative duration of diabetes, pancreatic reserve, the surgical technique applied, and adherence to post-operative lifestyle changes. The decision to discontinue medications must be made by your doctor.

Q: Are the risks of diabetes surgery higher than gastric bypass or sleeve gastrectomy?

A: Some techniques applied for diabetes surgery (e.g., more comprehensive malabsorptive procedures like Duodenal Switch or SADI-S) can be technically more complex than gastric bypass or sleeve gastrectomy, and the long-term risk of nutritional and vitamin-mineral deficiencies may be higher. However, each operation has its own specific risk profile. Your surgeon will discuss the potential benefits and risks in detail with you when choosing the most appropriate technique for you.

Q: Will I have to use vitamins for life after surgery?

A: Yes, especially after diabetes surgery procedures with malabsorptive effects (gastric bypass, SADI-S, etc.), the absorption of many vitamins and minerals (B12, iron, calcium, D vitamin, fat-soluble vitamins, etc.) will be impaired, so it is absolutely necessary to use these supplements regularly for life and under doctor supervision. Otherwise, serious health problems may arise.

Q: Is there a risk of diabetes recurrence after diabetes surgery?

A: Remission (improvement) achieved with diabetes surgery is generally long-lasting. However, if post-operative lifestyle changes (healthy eating, regular exercise, weight control) are not adhered to, there is a risk of some weight regain and diabetes recurrence over time (especially after many years). Therefore, lifelong follow-up and maintenance of healthy living habits are very important.