How Weight Loss Surgery Helps Type 2 Diabetes
Weight loss surgery can make a big difference for people with type 2 diabetes. For some people, blood sugar levels get back to normal after surgery. Diabetes can be cured.That could mean you need less medication or none at all. Research shows improvements in type 2 diabetes after weight loss surgery. One long-term study tracked 400 people with type 2 diabetes. Six years after bariatric surgery, 62% showed no signs of diabetes. They also had better blood pressure, cholesterol, and triglyceride levels. In comparison, only 6% to 8% of people who took medicine, but didn’t have surgery, showed similar results. If you’re thinking about it, and you’re ready to make big changes to keep up the results, you’ll want to know if it’s right for you. First, your doctor will consider two things: Is your BMI 35 or higher? Have you tried to lose weight and keep it off without success? If so, he will give you a detailed checkup and ask you questions to see if you are physically and emotionally ready for the operation and the major changes you'll need to make. (You'll need to eat a lot less and make a healthy diet and exercise part of your life forever.) Depending on your particular case, other doctors may also get involved. For instance, if you have heart disease, your cardiologist would need to approve you for surgery. There are different kinds of operations. Some help you lose weight by shrinking the size of your stomach so you feel full after small meals. Others change the way your body absorbs calories, nutrients, and vitamins. Still others do both. Get to know what’s involved with each of these: 1. Gastric bypass (also called Roux-en-Y gastric bypass) The surgeon makes a small stomach pouch by dividing the top of the stomach from the rest of it. When you eat, food goes to Continue reading >>
Can Bariatric Surgery Cure Type 2 Diabetes?
Can Bariatric Surgery Cure Type 2 Diabetes? More and more studies claim that the answer may be "yes"; in many cases, bariatric surgery is an effective cure for those suffering from type 2 diabetes. To be clear, diabetes is not well understood and medical science cannot claim a permanent cure. The goal is to put diabetes in remission. Remission means a return to normal blood sugar levels and no need for diabetes medications. With glucose at normal levels, the progression of diabetic complications is halted, thus giving the body a chance to repair the damage. In other words, remission means that you are presently "cured" and will remain so, unless the factors causing the disease return to a degree sufficient to cause a relapse. So, the correct question is, does bariatric surgery cause type 2 diabetes to go into remission? And, in many cases, the answer is a resounding yes. How does bariatric surgery cure Type 2 diabetes? We know that bariatric surgery puts type 2 diabetes into remission; what we dont know is how it does it. It's clear that healthy weight loss plays a significant role in reducing blood sugar levels in Type 2 diabetics, and bariatric surgery has been proven to be the most effective way for obese patients to lose significant body weight. But, there are additional factors at work. Many see an instant reversal of their diabetes immediately after gastric bypass surgery or gastric sleeve surgery before they lose any weight. This is what science doesn't fully understand. One theory suggests that bypassing or removing part of the stomach immediately impacts the way glucose is processed in the digestive system. Another claims that by shunting food directly to the lower intestine, a substance called glucagon-like peptide 1 (GLP-1) is stimulated, which can increase Continue reading >>
Why The New Surgical Cure For Diabetes Will Fail!
Two seemingly groundbreaking studies, published this week in the New England Journal of Medicine found that type 2 diabetes, or “diabesity”, could be cured with gastric bypass surgery. The flurry of media attention and medical commentary hail this as a great advance in the fight against diabetes. The cure was finally discovered for what was always thought to be a progressive incurable disease. But is this really a step backwards? Yes, and here’s why. No one is asking the most obvious question. How did the surgery cure the diabetes? Did the surgeons simply cut out the diabetes like a cancerous tumor? No. The patients in the studies changed their diet. They changed what they put in their stomach and that’s something that doesn’t require surgery to change. If they had surgery and they didn’t stop binging on donuts and soda they would get violently ill and vomit and have diarrhea. That’s enough to scare anyone skinny. If I designed a study that gave someone an electric shock every time they ate too much or the wrong thing, I could reverse diabetes in a few weeks. But you can get the benefits of a gastric bypass without the pain of surgery, vomiting, and malnutrition. Most don’t realize that after gastric bypass diabetes can disappear within a week or two while people are still morbidly obese. How does this happen? It is because food is the most powerful drug on the planet and real whole fresh food and can turn on thousands of healing genes and hundreds of healing hormones and molecules that create health within days or weeks. In fact, what you put on your fork is more powerful than anything you can find in a prescription bottle. The researchers asked the wrong question. It should not have been does surgery work better than medication, but does surgery work b Continue reading >>
Metabolic And Bariatric Surgery And Type 2 Diabetes
Did You Know? Someone in the world dies from complications associated with diabetes every 10 seconds. Diabetes is one of the top ten leading causes of U.S. deaths. One out of ten health care dollars is attributed to diabetes. Diabetics have health expenditures that are 2.3 times higher than non-diabetics. Approximately 90 percent of type 2 diabetes mellitus (T2DM), the most common form of diabetes, is attributable to excessive body fat. If current trends continue, T2DM or pre diabetic conditions will strike as many as half of adult Americans by the end of the decade. (according to the United HealthGroup Inc., the largest U.S. health insurer by sales). The prevalence of diabetes is 8.9 percent for the U.S. population but more than 25 percent among individuals with morbid obesity. Metabolic and bariatric surgery is the most effective treatment for T2DM among individuals who are affected by obesity and may result in remission or improvement in nearly all cases. Type 2 Diabetes Mellitus (T2DM) Type 2 diabetes(T2DM) is the most common form of diabetes, accounting for approximately 95 percent of all cases. Obesity is the primary cause for T2DM and the alarming rise in diabetes prevalence throughout the world has been in direct association increase rates of obesity worldwide. T2DM leads to many health problems including cardiovascular disease, stroke, blindness, kidney failure, neuropathy, amputations, impotency, depression, cognitive decline and mortality risk from certain forms of cancer. Premature death from T2DM is increased by as much as 80 percent and life expectancy is reduced by 12 to 14 years. Current therapy for type 2 diabetes includes lifestyle intervention (weight-loss, appropriate diet, exercise) and anti-diabetes medication(s). Medical supervision and strict adh Continue reading >>
How Does Gastric Bypass Surgery Cure Type 2 Diabetes?
Gastric bypass surgery often improves the symptoms of type 2 diabetes, even before patients start to lose weight. Why? “What we found is that the secret for the cure of diabetes after gastric bypass lies in the intestine,” said Dr. Nicholas Stylopoulos, principal investigator at the Division of Endocrinology at Children's Hospital Boston and Boston Medical School, in an interview with Healthline. “The key message is that after gastric bypass the intestine becomes the most important tissue for glucose use and this decreases blood sugar levels.” His research was published last week in the journal Science. Doctors are hopeful they can find a way to mimic the processes that lead to improvements for type 2 diabetics after gastric bypass without actually doing the surgery. Small Intestine to the Rescue Here's how it works: After gastric bypass, which is a common weight loss solution for the severely obese, the small intestine spontaneously begins to produce a molecule called GLUT-1 that helps the body use glucose. “The quite amazing thing is that this is not present normally in the small intestine of adults, but only in the fetus,” said Dr. Erini Nestoridi, a research fellow in Stylopoulos' lab, in an interview with Healthline. “This happens most likely because the intestine has to work harder to do its job, for example to absorb the nutrients or move the food further down. Also, it may be that the mechanical stress of 'dumping' the food directly to the intestine, since the stomach is bypassed, contributes to these changes.” Although weight loss and improved diabetes symptoms go hand in hand, previous research has shown that gastric bypass surgery helps resolve the disease even before weight loss occurs. According to the U.S. Centers for Disease Control and Pr Continue reading >>
Is Weight Loss Surgery The Answer For Diabetes?
With commentary by Anita P. Courcoulas MD, MPH, FACS, professor of surgery and director of minimally invasive bariatric & general surgery at the University of Pittsburgh Medical Center Is weight-loss surgery better than nutrition and physical activity alone for reversing type 2 diabetes? That controversial question has occupied researchers, doctors, insurers and people with diabetes for more than a decade. Now, a small yet well-designed study seems to have the answer: Surgery. University of Pittsburgh researchers randomly assigned 61 obese women and men with type 2 diabetes to receive gastric bypass surgery, an adjustable gastric band or an intensive lifestyle change program. Study volunteers were tracked closely for three years, as scientists monitored their weight, fasting blood sugar, A1c levels (a test of long-term blood sugar control) and use of insulin and other diabetes medications. The results: More weight (and fat) lost: Gastric bypass recipients lost an average of 25% of their body weight (and nearly 11% of their body fat), gastric band wearers dropped 15% of their weight (and 5.6% of their body fat) and lifestyle group members lost 5.7% of their weight and 3% of their body fat. People in the gastric bypass also saw their waist size shrink the most, an indicator that they’d lost the most visceral fat – the kind that packs around internal organs and contributes to blood sugar processing problems. Lower blood sugar: People in the gastric bypass group saw fasting blood sugar drop 66 mg/dL and their A1c levels fall 1.4%. In comparison, gastric band recipients got a 35-point reduction in fasting blood sugar and a 0.8% reduction in A1c levels. For the lifestyle-only group, fasting blood sugar fell an average of about 28 mg/dL but A1c levels rose slightly. Less d Continue reading >>
Bariatric Surgery For People With Type 2 Diabetes And Prediabetes
Bariatric surgery for people with type 2 diabetes and prediabetes Q: What is type 2 diabetes? What is prediabetes? Type 2 diabetes is a chronic, degenerative disease that develops when the body cannot make enough, or properly use, insulin a hormone that helps regulate sugar (glucose) in the body. Prediabetes is a precursor to type 2 diabetes, defined by above-average glucose levels. Q: Do bariatric surgeries (Roux-en-Y gastric bypass, adjustable gastric banding and vertical sleeve gastrectomy) cure type 2 diabetes? A: Patients are often told weight loss surgeries will cure diabetes. Thats simply not true. However, individuals with type 2 diabetes or prediabetes and obesity may benefit from the modest weight loss achieved through surgery. After a gastric bypass or a sleeve gastrectomy, patients experience weight loss and changes in their gastrointestinal tract. Weight loss surgery causes profound changes in the incretins -- hormones in the gastrointestinal tract that cause insulin to be released. These changes lead to significant improvement in type 2 diabetes and can cause long-term changes in the pancreas that causes diabetes to go away. Decrease the amount of medications they need on a daily basis Postpone the onset of diabetes (for individuals with prediabetes) Q: How can weight loss surgery affect diabetes treatment? A: Modest weight loss can postpone the onset of diabetes for people with prediabetes. If diabetes is in the early stages, the individual might be able to stop taking diabetes medications (such as metfromin or insulin) for many years. For people with longstanding diabetes, taking oral medications, the effects of surgery may allow sugar levels to be controlled with food restrictions only. If the diabetes has been present for more than 10 years and progre Continue reading >>
Obesity Action Coalition Dear Doctor Can Bariatric Surgery Treat Type 2 Diabetes?
Dear Doctor -Can Bariatric Surgery Treat Type 2 Diabetes? Answer provided by Lloyd Stegemann, MD, FASMBS To view a PDF version of this article, click here . Diabetes is a devastating problem worldwide. It has been estimated that as much as 8.3 percent of the worlds population has diabetes and this number is on the rise. As your weight goes up, so does your risk of developing type 2 diabetes (T2D). In fact, almost 25 percent of individuals who are affected by severe obesity (body mass index greater than 35) will carry a diagnosis of T2D. Uncontrolled diabetes leads to a host of long-term problems including heart attacks, strokes, kidney failure, blindness and the need for amputations. For many years, bariatric surgeons have known that bariatric surgery has a profound effect on T2D. It is not uncommon for our T2D patients to come off of all of their diabetic medications after bariatric surgery. Many primary care physicians (PCP), however, have been reluctant to advise bariatric surgery as the first line of treatment for their patients affected by severe obesity with T2D because of the lack of quality studies comparing the effectiveness of medical therapy versus surgical therapy for the treatment of T2D. Two recent studies that appeared in the New England Journal of Medicine were designed to help answer this question. In the first study, known as the STAMPEDE trial, 150 poorly controlled diabetic patients were divided randomly and equally into three groups. All of the patients in the study received intensive medical therapy including lifestyle counseling, weight management, frequent blood sugar monitoring, and diabetic medications. Fifty of the patients then continued with this intense medical therapy, 50 underwent a roux-en-y gastric bypass surgery, and the other 50 pati Continue reading >>
Weight-loss Surgery Can Reverse Diabetes, But Cure Is Elusive
Bariatric surgery can help obese people lose weight, and excess weight is a big risk factor for Type 2 diabetes. So it makes sense to try to figure out whether the surgery could help control diabetes, too. So far the answer is yes, at least for some people and for three years. But surgery doesn't work for everyone, and the long-term implications remain unclear. More than one-third of the people who had gastric bypass surgery met glycemic control targets three years out, compared with 24 percent who had a different type of bariatric surgery called sleeve gastrectomy. And just 5 percent of people in a group treated with medication alone were able to meet that standard. It's one of the first randomized controlled trials to look at bariatric surgery as a treatment for Type 2 diabetes, which affects 23 million adults. Still, almost three-quarters of the people who had surgery didn't meet the study's target of normal blood sugar, or 6 percent on an A1C test. And some of the people who had surgery still needed to use glucose-lowering drugs, including insulin. "Even though they did not achieve that target, they did get a lot better," says Dr. Philip Schauer, director of the Bariatric and Metabolic Institute at the Cleveland Clinic, who led the study. The people who had surgery lowered their blood glucose levels 2.5 percentage points, on average, compared with 0.6 points for the people who didn't get surgery. The people who lost the most weight and those who had been diagnosed with diabetes no more than three years before surgery did best, Schauer tells Shots. "If you want to achieve a long-term remission, intervene sooner rather than later," he says. The results were presented at a meeting of cardiologists in Washington, D.C., and published online Monday by the New England Jour Continue reading >>
The Role Of Bariatric Surgery To Treat Diabetes: Current Challenges And Perspectives
The role of bariatric surgery to treat diabetes: current challenges and perspectives 1 Carel W. le Roux ,2,3 and Alexander Kokkinos 1 1First Department of Propaedeutic Internal Medicine, Diabetes Centre, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece 1First Department of Propaedeutic Internal Medicine, Diabetes Centre, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece 2Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland 3Investigative Science, Imperial College London, London, UK 1First Department of Propaedeutic Internal Medicine, Diabetes Centre, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece 1First Department of Propaedeutic Internal Medicine, Diabetes Centre, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece 2Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland 3Investigative Science, Imperial College London, London, UK Chrysi Koliaki, Email: [email protected] . Received 2017 May 27; Accepted 2017 Aug 6. Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated. Bariatric surgery is emerging as a powerful weapon against severe Continue reading >>
New Study: Weight-loss Surgery May Cure Diabetes
New study: Weight-loss surgery may cure diabetes It seemed too good to be true when 60 Minutes reported it in 2008, but a new study confirms that weight-loss surgery can put type 2 diabetes in remission Could weight-loss surgery be a cure for type 2 diabetes? That's exactly what a new study, published today by the New England Journal of Medicine, suggests. The study showed that weight-loss surgery is dramatically more effective in the treatment of type 2 diabetes than a conventional treatment of diet changes and medication. Patients in the study suffered from severe type 2 diabetes, and most went into remission after undergoing one of two bariatric surgeries. "It's an unprecedented effect that we've never seen in diabetes before," says surgeon Dr. Francesco Rubino, senior author of the NEJM study and director of The Diabetes Surgery Center at New York-Presbyterian Hospital/Weill Cornell Medical Center. "Remission hasn't even been a word in the textbooks about diabetes." Doctors have been performing bariatric (or weight-loss) surgeries since the 1950s. Until now, the procedures have been considered just a treatment for morbid obesity. "The name 'bariatric' comes from a Greek term 'baros,' which means weight," explained Dr. Rubino. "In the 1950s, there were anecdotal reports that diabetes disappeared after these surgeries, but it was considered a side-effect of weight loss." Four years ago, Dr. Rubino was interviewed by Lesley Stahl for a 60 Minutes report on gastric bypass surgery as a potential cure for diabetes. "At the time it was little more than an exciting pie-in-the-sky theory," says 60 Minutes producer Shachar Bar-On, who worked with Stahl on story. Back then, Dr. Rubino had been performing the surgeries on diabetic rats, effectively reversing the animals' diabe Continue reading >>
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Weight Loss Surgery: Diabetes Cure?
Sept. 8, 2014 -- Weight loss surgery is an expensive and potentially risky way to treat type 2 diabetes . Yet more studies are showing it can also be very successful -- in some cases, more so than drugs and lifestyle changes. Despite what experts are calling remarkable results, though, theyre not saying weight loss surgery is a cure. Heres what they do know: A recent study found that type 2 diabetes can stay in remission for as long as 15 years after weight -loss surgery. Remission happens when a person with diabetes achieves blood sugar levels no longer in the diabetes range without medications for at least one year. The research bolstered previous shorter-term findings that suggest the surgery somehow changes the bodys metabolism and calms diabetes in certain people. Surgeons who routinely do the surgery say they're not surprised at the study's findings. It showed that 30% of people with type 2 diabetes were in remission 15 years post-surgery, compared to 7% whose diabetes was managed with drugs and lifestyle changes. Surgery could be a life-saver for certain obese people with diabetes, experts say. They include people who: Have tried to lose weight by traditional methods but could not Even among people with diabetes who are good candidates, surgery should not become the first treatment they try, experts say. We are absolutely the last stop. We are there for the person who has tried everything, says Richard Stahl, MD. He's the medical director of bariatric surgery at the University of Alabama at Birmingham. Recovering from surgery can take up to 2 weeks. Also, people who get surgery must still make major lifestyle changes to keep the benefits. Its not a simple fix, its a big ordeal to qualify for, and its not simple to recover from, Stahl says. Nor is it typically co Continue reading >>
Why Weight-loss Surgery Cures Diabetes: New Clues
Scientists are a step closer to understanding why diabetes is cured in the majority of patients that undergo gastric bypass surgery."Our research centered on enteroendocrine cells that 'taste' what we eat and in response release a cocktail of hormones that communicate with the pancreas, to control insulin release to the brain, to convey the sense of being full and to optimize and maximize digestion and absorption of nutrients," said the study's team leader. Scientists at The University of Manchester are a step closer to understanding why diabetes is cured in the majority of patients that undergo gastric bypass surgery. The research, published in the journal Endocrinology, shows the cure is likely to be explained by the actions of specialized cells in the intestine that secrete a cocktail of powerful hormones when we eat. During the research, the team showed that gut hormone cells previously thought to contain just one hormone, had up to six hormones including the hunger hormone ghrelin. Study team leader, Dr Craig Smith, a Senior Lecturer in Molecular Cell Physiology, said: "Our research centred on enteroendocrine cells that 'taste' what we eat and in response release a cocktail of hormones that communicate with the pancreas, to control insulin release to the brain, to convey the sense of being full and to optimize and maximize digestion and absorption of nutrients." "Under normal circumstances these are all important factors in keeping us healthy and nourished. But these cells may malfunction and result in under or over eating." 75% of people suffering from obesity who also have diabetes are cured of diabetes after receiving a gastric bypass and Dr Smith says that understanding how bypass surgery cures diabetes is the crux of his team's research. Dr Smith: "This is wh Continue reading >>
Curing Diabetes: The Only Confirmed (pseudo) Cure
Curing diabetes has been a goal of physicians and diabetic patients since it was first discovered by the Ancient Greeks in the 1st century (1). Almost 2,000 years later, it seems that we have finally learned how to cure diabetes, or at least provide a “pseudo-cure” that puts diabetes into potentially permanent remission: bariatric surgery. Review and click the sections below to learn more about the only known cure for diabetes. Continue reading >>
The Solution For Obesity And Diabetes Already Exists. So Why Do So Few People Know About It?
If your appendix fails, surgery is your best option. Blocked arteries? Surgery. Obesity and diabetes? Until recently, the most obvious solutions were diet, exercise, and drugs as needed; however a growing body of research suggests the optimal way to manage these conditions is with—that's right—surgery. "Why isn't every type 2 diabetic referred for an operation?" says Mitchell Roslin, MD, chief of bariatric and metabolic surgery at Lenox Hill Hospital in New York City. "I ask myself this every day." His puzzlement stems from a raft of recent reports about the stunning long-term effects of bariatric surgery on diabetes, as well as weight loss. The Cleveland Clinic's groundbreaking STAMPEDE (a charming acronym for the clunkily named Surgical Therapy And Medications Potentially Eradicate Diabetes Efficiently) study, published in 2012, was the first to show that bariatric surgery is more effective than medicine in controlling diabetes in obese people. The Cleveland Clinic has since published a follow-up study showing that gastric bypass surgery significantly improves and, in fully 50% of the cases they looked at, even reverses diabetes. There are several types of bariatric surgery, but the most common reduce the size of the stomach with a gastric band or through removal of a portion of the stomach (called sleeve gastrectomy), or resect and re-route the small intestine to a small stomach pouch (gastric bypass surgery). "It's amazing, honestly," says lead investigator Philip Schauer, MD, director of the Cleveland Clinic Bariatric and Metabolic Institute of the results his team compiled. "We hesitate to use the word 'cure' because that means no more diabetes for the rest of one's life. Remission is more accurate; it means blood sugar is normal without medication. But it is Continue reading >>