Tuesday, February 20, 2024

Case study of a 41 year old woman successfully underwent diabetes surgery at Wockhardt Hospitals Mira Road

L TO R : Dr Pankaj Dhamija, patient Ms Kavita, Dr Ramen Goel and Dr Rajiv Manek

Diabetes Surgery Successfully Performed on A 41-Year-Old Woman with Uncontrolled Diabetes of over 10 Years and Effectively Minimizing the Likelihood of Complications

“Diabetes or Metabolic Surgery involves laparoscopically rerouting the stomach & intestines to stimulate hormones which helps in diabetes treatment. "

"To qualify for surgery, the patient should be 18 years or older, should have uncontrolled type 2 diabetes, even after taking regular medicines, body mass index (BMI) should be 27.5 or more, indicating a weight excess of roughly 8-10 kilograms, Individual assessments are done to evaluate pancreatic function, associated co-morbidities, and suitability for anaesthesia." said Dr Ramen Goel

After surgery, the recovery period is swift, the blood sugar improves rapidly and most patients no longer depend on insulin or medication

Mumbai: A team headed by Dr Ramen Goel, Director, Diabetes & Metabolic Surgery Department, Wockhardt Hospitals, Mira Road achieved a breakthrough by successfully conducting a diabetes surgery on a 41-year-old woman who has been battling uncontrolled diabetes for over a decade. The patient also suffered from other health issues like high blood pressure, high cholesterol and thyroid problems, which greatly affected her overall well-being. This surgical intervention has been gaining traction for the last 1 year and significantly reduces the chances of developing complications associated with diabetes, such as diabetic retinopathy, brain stroke, kidney disease, and cardiac and nerve problems, all of which contribute to higher mortality rates in our country. Remarkably, this surgery improves blood sugar levels, aids quick recovery and the patient has now completely stopped taking diabetes medication and has seamlessly resumed her daily activities.

Patient Mrs Kavita Mahesh, a 41-year-old resident of Mira Road, weighing 84.5 kgs had uncontrolled diabetes for 10 years besides high blood pressure, high cholesterol and thyroid. Additionally, her father has kidney problems. Despite taking the medication regularly, her blood sugar levels remain uncontrolled. In November, the patient approached Wockhardt Hospitals, Mira Road, and sought assistance due to her inability to control her blood sugar levels and the presence of high cholesterol.

Dr Ramen Goel, Consultant Diabetes and metabolic surgeon, Wockhardt Hospitals Mira Roadsaid, “The prevalence of diabetes mellitus is rapidly growing, affecting a staggering number of people in the country. Despite extensive awareness campaigns and lifestyle modifications, over 77% people with diabetes, have failed to achieve proper control over their condition (indicated by HbA1c levels above 7). As a result, patients with uncontrolled diabetes face an increased risk of developing macrovascular complications such as cardiovascular diseases (including heart attacks) and brain strokes, as well as microvascular complications like peripheral neuropathy and nephropathy. The impact of this disease extends beyond a reduced lifespan, with an estimated millions of lives in India being lost due to direct causes related to diabetes. Hence, diabetes surgery can be a boon for patients with high HBA1c levels that help to regularise average blood sugar levels within 2-3 months.”

“Diabetes surgery is a laparoscopic gastrointestinal procedure that reroutes the stomach and the intestines. In India, gastric bypass and sleeve gastrectomy are commonly performed metabolic surgeries. While these surgeries were originally intended for weight loss, they can now be offered to patients with a BMI of 27.5 who have uncontrolled diabetes. The surgeries work by changing gut hormones, and gut bacteria, and limiting food intake, resulting in improved insulin sensitivity, increased insulin secretion, and better glycemic control.  Its purpose was to redirect food to the latter part of the intestine, which secretes a hormone called GLP-1. This hormone reduces insulin resistance and stimulates increased insulin production from the pancreas. The surgery was done on February 6th, and the patient was discharged on February, 9. The surgical procedure typically takes around one hour, and patients are allowed to drink water and walk within 6-8 hours after surgery. She is completely off diabetes medicines 1 week after discharges and her HAB1C levels has already dropped by 10%   The recovery process after metabolic surgery is relatively quick and the blood sugar levels start improving within the first two days after surgery. In most cases, injectable insulin can be discontinued within 2-7 days post-surgery,” said Dr Goel.

Individuals who undergo diabetes surgery experience glycemic resolution, and their blood sugar levels return to normal and most no longer require medication.  “Most patients continue to be free from diabetes medication even a decade after the surgery. This sustained maintenance of normal blood sugar levels has a remarkable impact on reducing complications associated with diabetes. After diabetes surgery, there is a reduction in diabetic retinopathy (eye problems), diabetic kidney disease, and diabetic nerve problems. There is also a decrease in diabetes-related heart attacks and deaths. The achievement of glycemic control and the avoidance of complications are crucial factors in managing diabetes effectively,” underscored Dr Ramen Goel.

Wockhardt Hospitals, Mira Road has taken a pioneering step by introducing metabolic surgery in North Mumbai. This innovative procedure goes beyond traditional weight loss surgeries, as it is specifically designed to treat diseases such as diabetes and hypertension and transform lives for the better. This commitment to improving patients' overall health reflects the Hospital's dedication to providing holistic healthcare solutions that go beyond mere symptomatic treatment; highlighted Dr. Pankaj Dhamija, Centre Head, Wockhardt Hospitals, Mira Road.

“Dr Goel transformed my life by performing the surgery which not only improved my blood sugar levels but also hopefully saved me from dangerous complications. Before the surgery, I was constantly battling high blood sugar levels despite multiple medications and strict dietary control. It felt like an endless cycle of frustration and despair. Dr. Goel's expertise in diabetes surgery offered a glimmer of hope for a better future.  It not only drastically reduced my blood sugar levels but also provided me with newfound freedom and peace of mind. My quality of life has significantly improved and I now enjoy activities that were once lost to chronic fatigue due to uncontrolled diabetes. He explained how reducing excess weight through metabolic surgery can lead to improvements in blood pressure, cholesterol levels, and overall cardiovascular health by reducing the risk of complications. I am forever indebted to Dr Goel and his team,” concluded the patient Mrs Kavita Mahesh

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