Diabetes mellitus type 2 surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]

Overview

Pancreas and islet cell transplantation is considered in patients with chronic diabetes who have frequent metabolic complications and are intolerant to exogenous insulin or have failed insulin therapy.

Surgery

There is no indication for surgery in type 2 diabetes mellitus unless, there is an indication for pancreas and islet cell transplantation. Pancreas and islet transplantation have been shown to normalize glucose levels but require lifelong immunosuppression to prevent graft rejection and recurrence of autoimmune islet destruction. Islet cell transplantation remains investigational. Pancreas transplantation is considered for patients with chronic diabetes and multiple complications.
Indication for pancreas transplantation is:

• Patients who have history of frequent severe metabolic derangement (hypoglycemia, marked hyperglycemia, ketoacidosis), intolerant to exogenous insulin therapy or failure of treatment with insulin.