The increase in diabetes in the last 30 years has led to the search for a remedy. Although the pharmaceutical industry offers hundreds of different drugs and synthetic insulin as a remedy for the treatment of diabetes, the success of these methods is only around 60-65% . The surgical methods used in the treatment of diabetes were generally advanced types of methods used in obesity surgery. The biliopancreatic method developed by Italian surgeon Nicola Scopinaro is the first of these methods. This method, which reduces blood sugar up to 98%, has a serious effect on the patients, and the patients who had this surgical intervention had to live with vitamin supplements for the rest of their lives. So, the patients got rid of insulin, but had to consume vitamin pills.

The type of diabetes seen in adults is called type 2 diabetes. The pancreas produces insulin, but due to insulin resistance, the body cannot use it properly. Type 2 diabetes occurs mostly in people over 40 years old. The symptoms of type 2 diabetes are; polyuria (frequent urination), polydipsia (the need to drink a lot of water), weight gain or loss, increased blood glucose (greater than 126 mg/dl on an empty stomach), dry mouth, fatigue, blurred vision, delayed healing of body wounds, dry and itchy skin, frequent infections, sexual problems, numbness or tingling in the hands, feet or around the mouth.

The first step in the treatment of type 2 diabetes;
· Diet, i.e. the regulation of nutritional habits,
· Changing the lifestyle
· Carrying out exercise programs

Obesity is the excess of fatty tissue and high weight gain. The factors that determine obesity are genetic factors, external environment, socioeconomic status, metabolic diseases and medications. In general, patients are used to blaming these factors; the most important cause of obesity is the large consumption of food.

Nowadays, the work rhythm of life, the reduced time in the kitchen, foods that are prepared quickly, have entered more into our lives. These foods are far from vegetables and fruits, being foods rich in sugar, fats and calories, being liked by children and young people. Living a life away from movement and driving cars even for small distances, especially the time spent in front of the computer and the TV, obesity becomes inevitable. Obesity is not only an aesthetic problem, but brings many diseases; type 2 diabetes, hypertension, heart disease, menstrual cycle disorders, increased pregnancy complications, gallstones, fatty liver, sleep apnea, osteoarthritis and depression, these being some of them.

The picture of high weight, diabetes, cholesterol and high blood pressure is called Metabolic Syndrome. The treatment of metabolic syndrome using surgical methods is called Metabolic Surgery.The entity called Metabolic Syndrome, which is explained by excessive weight or obesity, type 2 diabetes, hypertension and disorders of cholesterol metabolism, is a cause of death because it causes serious organ damage, loss of jobs and significant financial losses, such as and cardiovascular diseases. The frequency of Metabolic Syndrome and obesity is increasing worldwide. It is known that 1.1 billion of the world’s population is overweight and approximately 400 million are obese (body mass index > 30). Metabolic diseases, such as type 2 diabetes, coronary artery disease and hypertension, can be counted among the most important diseases that accompany obesity. It is also known that cancer is more common in obese patients.

Before the operation: 1-2 days before the operation, you will be hospitalized and you will be given blood thinners and laxatives to clean the intestines. . Blood sugar and blood pressure will be controlled. You will have to take a liquid diet (such as water, fruit juices, soup, tea, whipped milk, compote) 1 day before the operation and not eat or drink anything after 10:00 pm. This will keep your bowels clean, so you don’t need an enema, the operation is clean and the risk of infection is reduced.

During the operation: To check your blood pressure during the operation, an oxygen measuring probe will be attached to your finger, to check the blood oxygen saturation and with a blood pressure device, which will automatically measure your blood pressure arterial. The vascular access will be opened in your arm, to ensure the flow of anesthesia and other medicines. While you are under anesthesia, to ensure sufficient and safe fluid flow after metabolic surgery, catheters will be inserted that provide access to the vein in your hand or arm.

The appearance of these surgeries comes from obesity operations, such as DS (Duodenal Switch) and BPD (Biliopancreatic Diversion), in which a very important part of the small intestine is closed when food enters and is voided. >

The most important difference of metabolic surgery compared to obesity operations is the working mechanism, based on the principles of not inactivating the small intestines by bypass and taking advantage of hormonal changes with a transposition procedure.Another difference is in the positive effects of changing the order of hormones in Metabolic Surgery applications, on patients with type 2 diabetes, regulating blood sugar, who do not have major weight problems, independent of weight loss. For this purpose, there are 2 basic applications of metabolic surgery carried out in medical practice.The first of these is the Ileal Transposition (IT) and the second is the Bipartition (TB) transit operation.The IT procedure is a surgical technique that has been proven to be safe and has effective results even in patients with type 2 diabetes with lower body mass index (BMI) values.