I am Considering Metabolic Surgery For Patient whois Obese and has Type 2 Diabetes

Yıl 2018, Cilt: 6 Sayı: 4, 28 - 31, 02.04.2018

Prof. Dr. Asım Cingi

Öz

Abstract

Obesity and obesity related diseases endanger modern society as an unpreventable pandemic. Bariatric surgery has been performed with great success in the treatment of morbid obesity for many years. Treatment of obesity related diseases suchas type 2 diabetes, hypertension, fatty liver and dyslipidemia have expanded the targets of treatment and metabolic results have become as important as loosing excess weight. It has been observed that effective glycemic control could be achieved before substantial weight loss and both experimental and clinical studies suggested thatgastrointestinal tract manipulation could be used for the treatment of diabetes. In randomized trials metabolic surgical treatment has been shown to be superior to intense medical treatment for glysemic control in diabetic patients. Additionally it has been documented that metabolic surgery not only  achieved glycemic control butalso result in decrease in cardiovascular risk  with improvement in triglyseride and HDL-cholesterol levels as well as decrase in systolic and diastolic blood pressure.It is clear that metabolic surgery has and will have an important part in the treatmentalgorithyms of type 2 diabetes with expanding indications.

Anahtar Kelimeler

Metabolic surgery, Type 2diabetes, Obesity, Bariatricsurgery

Obezitesi ve Tip 2 Diyabeti Olan Hastada Metabolik Cerrahi Düşünüyorum

Öz

Öz

Obezite ve obezitenin tetiklediği hastalıklar önünü alamadığımız bir salgın olarak modern toplumu tehdit etmektedir. Bariatrik cerrahi yöntemler obezite tedavisinde uzun süredir etkin bir tedavi yöntemi olarak kullanılmaktadır. Tip 2 diyabet, hipertansiyon, yağlı karaciğer, dislipidemi gibi yandaş hastalıkların tedavisi, obez bireylerde planlanan cerrahi tedavilerin hedefini genişletmiş ve tedavinin metabolik olumlu sonuçları en az kilo vermek kadar önem kazanmıştır. Cerrahi sonrası henüz belirgin kilo vermeye yeni başlamışken bile glisemik kontrolün etkin bir şekilde sağlanabildiği anlaşılmış ve gastrointestinal sistem manüpülasyonları ile diyabet tedavisinde başarı sağlanabileceği hem deneysel hem deklinik çalışmalarda gösterilmiştir. Yapılan randomize karşılaştırmalı çalışmalarda diyabet kontrolü için metabolik cerrahi tedavi en iyi medikal tedaviye üstünbulunmuştur. Ayrıca metabolik cerrahi yöntemler ile elde edilen sonuçlar diyabet kontrolü ile sınırlı kalmamış ve  trigliserid ve HDL düzeylerinde iyileşme, sis-tolik ve diastolik kan basıncında azalma ile beraber kardiyovasküler risk azalma-sı sağlanabilmiştir. Tip 2 diyabet tedavisinde, cerrahi yöntemlerin giderek geniş-leyen endikasyon kriterleri ile tedavi algoritmalarının önemli bir parçası olmasıkaçınılmaz gözükmektedir.

Anahtar Kelimeler

Metabolik cerrahi, Tip 2 diyabet, Obezite, Bariatrikcerrahi

Kaynakça

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