Until now, diabetes has been considered a lifelong disease—something that can be managed but not cured. Patients depend on medication, diet control, and lifestyle changes to keep their blood sugar stable. But recently, Dr. Manjunath from the Department of Surgery at AIIMS claimed that a special procedure known as metabolic surgery can dramatically improve diabetes control—and in many cases, almost eliminate the need for diabetes medication. This surgery modifies the body's metabolic process and enhances insulin sensitivity, allowing blood sugar levels to drop naturally.

But this raises an important question: Can every diabetes patient go for this surgery? Let’s understand who qualifies, whether it is safe for all, and how the procedure works.

Who can undergo metabolic surgery?

According to Dr. Manjunath, metabolic surgery is not suitable for all diabetes patients. It is specifically recommended for people with:

• Type 2 diabetes
• Uncontrolled blood sugar levels
• Poor response to medications and insulin
• Overweight or obesity (high BMI), since obesity and diabetes are closely linked

Patients with type 1 diabetes cannot benefit from this surgery because their pancreas does not produce insulin, and the root cause of their disease is different.

Before the surgery, doctors thoroughly evaluate the patient’s medical history, age, heart health, kidney function, and overall risk factors to determine whether the surgery is safe and likely to be effective.

How metabolic surgery works

Metabolic surgery is similar to bariatric surgery. It involves modifying the stomach and intestines so the body digests food differently. This includes:

• Reducing the size of the stomach
• Reconnecting the intestine so food bypasses a portion of its normal path

This altered digestive process increases insulin sensitivity, which in turn helps blood sugar levels fall naturally.

The surgery is done laparoscopically—through small incisions—making recovery faster. Patients must undergo health screening before the procedure and follow a strict diet and lifestyle plan afterward for long-term success.

What should your sugar levels be?

The American Diabetes Association defines diabetes based on the following criteria:

HBA1C
• Normal: up to 5.7%
• Prediabetes: 5.7%–6.4%
• Diabetes: 6.5% or higher

Fasting blood glucose
• Normal: less than 100 mg/dL
• Prediabetes: 100–125 mg/dL
• Diabetes: 126 mg/dL or higher

Post-meal glucose
• Normal: less than 140 mg/dL
• Prediabetes: 140–199 mg/dL
• Diabetes: 200 mg/dL or higher

Metabolic surgery may offer hope to many type 2 diabetes patients, but it is not a universal cure. A doctor’s evaluation is essential before considering the procedure.