The gastric bypass heals 80-90% of type 2 diabetes even before the patient is discharged.
The metabolic changes produced by the bridging of part of the stomach “are so powerful” that the glycemic profile changes greatly and very rapidly in these patients, according to Gema Fruhbeck, a consultant in the Department of Endocrinology and Nutrition and director of the research laboratory. Metabolics of the University Clinic of Navarra (CUN).
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TYPE 2 DIABETES
It is a lifelong disease (chronic) in which there is a high level of sugar (glucose) in the blood. Type 2 diabetes is the most common form of diabetes.
CAUSES
Insulin is a hormone import produced in the pancreas by special cells, called beta. The pancreas is below and behind the stomach. Insulin is necessary to move blood sugar (glucose) to cells. Inside the cells, it is stored and subsequently used as an energy source.
When you have type 2 diabetes, adipocytes, hepatocytes and muscle cells do not respond correctly to that insulin. This is called insulin resistance. As a result of this, the sugar on the blood does not enter these cells to be stored as a source of energy.
When sugar can not enter the cells, a high level of blood accumulates, which is called hyperglycemia. The body is unable to use sugar as energy. This first to the symptoms of type 2 diabetes.
Typically, type 2 diabetes develops slowly over time. Most people with this disease are overweight or obese at the time of diagnosis medical. The increase in fat makes it difficult for the body to use insulin in the right way.
Type 2 diabetes can also occur in people who are not overweight or who are not obese. This is more common in older adults.
Family history and genes play an important paper in type 2 diabetes. A low level of activity, a poor diet and excessive body weight around the waist increase the risk of this disease.
DIABETES MELLITUS TYPE 2
Diabetes mellitus type 2 is a metabolic disorder characterized by high blood sugar level in the context of insulin resistance and relative lack of insulin, this frequently occurs in people suffering from morbid obesity or herentially; in contrast to diabetes mellitus type 1, consequently an absolute lack of insulin due to the destruction of the pancreatic islets. The classic symptoms are excessive thirst, frequent urination and constant hunger, these symptoms are determinants to diagnose diabetes in a person. Type 2 diabetes accounts for about 90% of diabetes cases, with the other 10% due mainly to diabetes mellitus type 1 and gestational diabetes. It is thought that obesity is the primary cause of type 2 diabetes among people with genetic predisposition to the disease (although this is not the case for people of East Asian descent).
Type 2 diabetes is initially controlled with increased exercise and changes in diet. If blood glucose does not fall well with these measures, medications such as metformin or insulin may be necessary. In patients treated with insulin, there is typically a requirement to routinely check blood glucose.
The rates of type 2 diabetes have increased markedly since 1960, in parallel with obesity. By 2010 there were approximately 285 million people diagnosed with the disease compared to about 30 million in 1985. Type 2 diabetes is typically a chronic disease associated with a reduction in life expectancy of ten years.4 The long-term complications of Hyperglycemia can include heart disease, stroke, diabetic retinopathy (affects vision), kidney failure that may require dialysis, and poor circulation in the extremities that leads to amputations. Ketoacidosis, an acute and characteristic complication of type 1 diabetes, is uncommon, however a hyperglycemic hyperosmolar coma may occur.
EPIDEMIOLOGY
The incidence of type 2 diabetes is increasing worldwide and reaches epidemic proportions. In 2010, it was estimated that it affected 285 million people, (approximately 6% of the adult population of the world) and represented about 90% of all cases of diabetes. Currently, it is estimated that these figures have increased to 347 million people.
Diabetes is common in both the developed and the developing world. However, it is still less frequent in underdeveloped countries.
Women seem to be at greater risk as are certain ethnic groups, 411 such as those from Southeast Asia, the Pacific Islands, Latinos and Native Americans. This may be due to a better sensitivity to a Western lifestyle in certain ethnic groups. Traditionally considered an adult disease, type 2 diabetes is increasingly diagnosed in children in parallel with rising rates of obesity. Type 2 diabetes is now diagnosed as frequently as type 1 diabetes in US adolescents.
Diabetes rates in 1985 were estimated at 30 million, which increased to 135 million in 1995 and 217 million in 2005. It is believed that this increase is mainly due to the aging of the world population, a decrease in the exercise and rising rates of diabetes. obesity. For 2000, the five countries with the highest number of people with diabetes were India (31.7 million), China (20.8), the United States (17.7), Indonesia (8.4) and Japan (6.8). The World Health Organization recognized diabetes as a global epidemic because it has spread due to the poor nutrition that people have.
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LIFESTYLE
It is known that a number of lifestyle factors are important in the development of type 2 diabetes, such as obesity and overweight (defined as a body mass index [BMI] More than 25), lack of physical activity, poor diet, stress and eating disorder. Excess body fat is associated with 30%, occurs in people of Chinese and Japanese descent, 60-80% in those of European and African descent and 100% in Pima Indians and Pacific Islanders. Those who are not obese usually have a high waist / hip index.
Dietary factors also influence the risk of developing type 2 diabetes, because at some point the body will lack some nutrients. Excessive consumption of sugar-sweetened beverages is associated with an increased risk. The type of fats in the diet is also important: saturated fats and trans fatty acids increase the risk and polyunsaturated and monounsaturated fats decrease it. Eating a lot of white rice seems to play a role in increasing the risk. It is believed that lack of exercise causes 7% of cases. Persistent organic pollutants may also play a role.
GENETICS
Most cases of diabetes involve many genes and each is a small contribution to a greater likelihood of becoming a type 2 diabetic. If an identical twin has diabetes, the chance that the other will develop diabetes during their lifetime is greater than 90%, while the rate for non-identical siblings is 25-50%. By 2011, more than 36 genes have been found that contribute to the risk of suffering from type 2 diabetes. However, such genes only represent 10% of the hereditary component of the disease. The TCF7L2 allele, for example, increases the risk of developing diabetes by 1.5 times and has the highest risk among common genetic variants. The majority of the genes linked to diabetes are involved in the functions of the pancreatic islets.
There are a number of rare cases of diabetes that arise due to an abnormality in a single gene (“other specific types of diabetes”). These include MODY type diabetes, Donohue syndrome and Rabson-Mendenhall syndrome, among others. MODY diabetes constitutes 1-5% of all diabetes cases among young people.
OTHERS FACTORS
There are medications and other health problems that can predispose to diabetes. Some of the medications are: glucocorticoids, thiazides, beta-blockers, atypical antipsychotics and statins. Women who have previously had gestational diabetes are at an increased risk of developing type diabetes. Other health problems that are associated include: acromegaly, Cushing’s syndrome, hyperthyroidism, pheochromocytoma and certain types of cancer, such as glucagonomas. Testosterone deficiency is also associated with type 2 diabetes.
