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Essay on Diabetes


Diabetes is a debilitating, life-threatening disease accounting for the death of millions of people every year all over the world, its out breaking prevalence as well as its hazards complications such as cardiovascular disease, renal disease and infectious diseases among others makes it a major health challenge of the twenty-first century and has led to the search for novel procedures that can provide sustained glycemic control (Harding et al., 2018).

According to the last estimations, about 415 million adults currently suffer from diabetes, and this number is expected to rise to 642 million by 2040 (Ogurtsova et al., 2019).

The ordinary management of type 2 diabetes mellitus (T2DM) includes lifestyle modulations and oral hypoglycemic drugs, insulin or combination between both (Chatterjee et al., 2017).

While the medications aim to maintain acceptable blood glucose levels, the lifestyle modulations aim to achieve loss of weight to target the underlying pathophysiology of T2DM (Tsilingiris et al., 2019).

The significant effects of bariatric and metabolic surgery regarding loss of weight and metabolic amendment have put it as a possibility for T2DM management. By addressing many complementary pathogenic mechanisms, bariatric surgery appears to be hopeful in the reversal of the metabolic abnormalities of T2DM (Rubino et al., 2016).

Ileal interposition enhance the insulin sensitivity and improve the ß-cell function in an effective way that overcomes the traditional medical therapy (Mingrone et al., 2013).

Laparoscopic ileal interposition associated with sleeve gastrectomy emerged as a choice for T2DM management due to its effect on glucose hemostasis as it intends to target the pathophysiology of the underlying mechanisms of the disease (DePaula et al., 2012).

The procedure combines between the restrictive role of the sleeve gastrectomy and the malabsorption role of the interposed ileal segment (Ugale et al., 2017).

The aim of the work

In this review we seek to illustrate, through the available researches, the role of laparoscopic ileal interposition associated with sleeve gastrectomy in management of type 2 diabetes mellitus and the feasibility and efficacy of this procedure as a promising option in management of T2DM and assess the risk to benefit profiles.


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