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With the global population aging and lifestyle changing, diabetes has become an more and more serious diseases of affluence. The formation of diabetes mostly comes from long-term unhealthy lifestyles, such as the lack of regular exercise and obesity caused by unhealthy diets, and this issue is prone to juvenility. In Taiwan, averagely one out of every 10 adults has the problem of diabetes, and it also seriously affects the health and quality of life of age between 40 to 60.

In the past, the treatment of Type 2 diabetes was often controlled by oral hypoglycemic agents or insulin injections, supplemented with regulating diet and exercise. However, these treatments are almost impossible to cure diabetes. Additionally, the long-term poor control of diabetes often leads to renal failure, retinopathy, and cardiovascular obstruction, which are even more unbearable.But now, the medical research has found that we can use surgery to treat diabetes.

Dr. Hsin Ming-Che, Body Science & Metabolic Disorders International Medical Center, China Medical University Hospital indicates that previous bariatric surgery using to treat morbid obesity presents not only good effects of weight loss, but allowing patients to change figure shape, lose weight, and also improve the three-increases, increased urination, thirst, and hunger caused from obesity. Now, the new generation of metabolic surgery can provide better anti-diabetic effects and quality of life than previous bariatric surgery.

Facing with the increasingly serious problems of obesity and diabetes, the International Diabetes Federation has included surgery into the guidelines of diabetes management in 2011. Taiwan Society for Metabolic and Bariatric Surgery also published the White Paper on expert guidelines of diabetes surgery. For the treatment of type 2 diabetes, upon encountering poor control of blood sugar from oral or injective medications, laparoscopic surgery can be applied to treat diabetes. 

Patients at younger age, short time from disease onset, and never use insulin have good effectiveness of surgery.
According to previous studies in the US and Taiwan, the bariatric surgery do improve type 2 diabetes. Most patients can get rid of the life of daily insulin injections and drug intake, HbA1c can be reduced to lower 6.0, known as remission, and even can be cured from diabetes. Why bariatric surgery can treat diabetes? The current studies suggest that the reasons may be related to the decreased body weight, altered gastrointestinal hormone secretion, and the reduced and raised sensitivity of insulin resistance. 

The current studies have also found that patients are no longer to take hypoglycemic drugs after bariatric surgery when they are younger, have a shorter duration from disease onset, and have never used insulin. However, when a patient has diabetes for more than 10 years and been administrated for high-dose of insulin, the blood sugar level will be improved after the surgery, but a small amount of medication may still be necessary.

Mr. Wang who lives in Taichung City, is a patient of Dr. Hsin Ming-Che. He is 51 years old and serves as a company executive. He was found to have the diabetes at the peak of his career and received a minimally invasive surgery of sleeve gastrectomy and intestinal bypass in October 2017. His condition is very good 10 months after the surgery. Before receiving the surgery, Mr. Wang liked to drink sugary drinks and with BMI 32.1 (height 185 cm, weight 109.8 kg), and he had severe fatty liver, gastric ulcer, and his weight once up to 118 kg. Because of his high height, he did not really care about his weight problem at first; and he also had diet control and reduced weight to 102 kg by refraining from eating rice and noodle. Yet in the end, the weight had regained from unsustainable. About 4 years ago, he started to have symptoms such as urinary frequency, easy to pant for breath and feel tired, and went to a clinic and diagnosed diabetes. He began to quit sugary drinks and started to take medicine to control diabetes. Mr. Wang’s daughter unexpectedly heard a speech about the diabetes can be treated by a metabolic surgery from Dr. Hsin Ming-Che and encouraged his father to consult. Mr. Wang decided to receive the surgery after evaluation and his weight reduced to the standard value after the surgery. Now he weighs 86 kg and BMI 25 without taking medicine, and the HbA1c, uric acid, kidney function indicators, c peptide are turned back to the normal values. Mr. Wang has regained a good quality of life.

Treat earlier to get rid of the type 2 diabetes
Of the 4000 patients of the Body Science & Metabolic Disorders International Medical Center, 800 cases had type 2 diabetes. By analyzing the surgical results of these patients, 70% of the cases did not need to take any drugs or inject insulin to achieve remission; the other 30% of cases still need to control by taking medicine and most of them were related to poor islet function. The progress of type 2 diabetes presents not only the decreased insulin resistance but the poor islet function year by year. Therefore, patient’s islet function need to be tested before surgery, and patients with good islet function have better postoperative effectiveness. In other words, for patients with older age and longer time of diabetes, the treatment efficacy turns worse. We suggest that the sooner the patients are treated, the sooner the diabetes can be escaped from.

Vietnamese obsess population increases; Metabolic surgery study exchanges to promote the superior medical technology of Taiwan
Since the more than 2 years establishment, Body Science & Metabolic Disorders International Medical Center, China Medical University Hospital has performed bariatric and metabolic surgery for nearly a thousand times. In addition to serve the Taiwanese people, we also treated many international patients from Singapore, Macau, Hong Kong, Philippines, China, Pakistan, etc. At present, the center is the only one international-class medical center in Asia which passed international SRC certification and integrates metabolic surgery and body sculpture treatment. In this May, Body Science & Metabolic Disorders International Medical Center had assisted Vietnam in holding the first metabolic surgery seminar in Vietnam through Taipei Economic and Cultural Office in Vietnam and the Council of Taiwanese Chambers of Commerce in Vietnam.

In recently years, with the growth of economic growth and changes in eating habits in Vietnam, people suffering from obesity and diabetes have increased yearly, and which has prompted the World Health Organization to issue various warnings to the Vietnamese government and society. Dr. Hsin Ming-Che visited Vietnam and held three metabolic surgery symposiums at the medical center of Ho Chi Minh City Medicine and Pharmacy University, Hanoi Vietduc University and Hospital, and Hanoi Bach Mai Hospital to introduce the concepts and techniques of metabolic surgery to Vietnam, which also created a new peak of Taiwan’s medical image by this medical diplomacy.

Dr. Hsin Ming-Che,

Body Science & Metabolic Disorders International Medical Center