Uncontrolled diabetes is emerging as a serious and largely silent health crisis in India, leading to irreversible organ damage and early mortality, warned a senior doctor from the All India Institute of Medical Sciences (AIIMS), New Delhi. Speaking on Wednesday, Dr. Manjunath Maruti Pol, Additional Professor in the Department of Surgery at AIIMS, said timely metabolic surgery could play a crucial role in preventing life-threatening complications in select patients with uncontrolled Type-2 diabetes.

India is already recognised as the diabetes capital of the world, with nearly 70 million people living with the disease. Alarmingly, Dr. Pol pointed out that close to 50 per cent of these patients suffer from uncontrolled diabetes, significantly increasing their risk of kidney failure, heart attacks, strokes, nerve damage, and vision loss. He noted that while the global benchmark for good blood sugar control, measured through HbA1c, is 7, the accepted threshold in India is higher at 7.5.

Dr. Pol explained that uncontrolled diabetes is defined as a condition where HbA1c levels remain above 7.5 despite consistent medication—three or more drugs—along with strict diet and lifestyle changes for at least two years. He stressed that rising HbA1c levels are directly linked to faster organ damage, stating that as blood sugar control worsens, the likelihood of organ failure and death increases sharply. Highlighting a shift in global medical practice, Dr. Pol said surgery is now an internationally recognised treatment option for selective cases of uncontrolled Type-2 Diabetes Mellitus (T2DM). The International Diabetes Federation formally acknowledged surgery as a treatment modality in 2016, marking a major breakthrough in diabetes care.

According to established guidelines, metabolic surgery can be performed on patients between 18 and 65 years of age. Unlike Type-1 diabetes, which involves the pancreas, surgery for Type-2 diabetes targets the stomach and small intestine. Dr. Pol explained that the procedure involves reducing the size of the stomach and rerouting a portion of the small intestine so that food bypasses the duodenum.

This anatomical change triggers the release of specific gut hormones, including GLP, in a natural rhythm and physiological dose, which helps regulate blood sugar levels effectively. “This process essentially halts further organ damage,” Dr. Pol said, adding that the surgery works independently of weight loss.

Sharing AIIMS’ clinical experience, Dr. Pol revealed that the institute has performed over 100 such surgeries, with 35 per cent of patients having uncontrolled Type-2 diabetes. Notably, all these patients are currently off diabetes medications. He also highlighted the rapid benefits of the procedure, stating that many patients achieve near-normal blood sugar levels as early as the first day after surgery.

The surgery, performed through laparoscopic or robotic methods, costs between Rs 3 lakh and Rs 6 lakh. While the cost may seem significant, Dr. Pol emphasised that the long-term benefits—reduced complications, improved quality of life, and freedom from lifelong medication—far outweigh the expense.

As diabetes-related complications continue to rise, experts believe metabolic surgery could offer a vital lifeline to carefully selected patients battling uncontrolled diabetes in India.