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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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 >>
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 >>
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 >>
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 >>
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 >>
Diabetes 'cure' After Weight Loss Surgery Lasts Long Term
Diabetes 'Cure' After Weight Loss Surgery Lasts Long Term Half of patients whose diabetes resolved following bariatric surgery still had complete or partial remission some 6 years later, researchers found. For best viewing, click the bottom right corner for full screen. by Kristina Fiore Kristina Fiore, Staff Writer, MedPage Today This article is a collaboration between MedPage Today and: Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal. This retrospective study suggests that bariatric surgery can induce significant long-term remission in type 2 diabetes. Bariatric surgery may keep type 2 diabetes at bay for good, researchers found. In a single-center study, 50% of patients whose diabetes resolved following bariatric surgery still had complete or partial remission of the disease about 6 years later, Stacy Brethauer, MD, of the Cleveland Clinic, and colleagues reported at the American Surgical Association meeting in Indianapolis. Of those who had a complete remission, 27% met the definition of a "functional cure" of diabetes, defined by the American Diabetes Association (ADA) as a glycated hemoglobin (HbA1c) under 6% and a fasting blood glucose under 100 mg/dL that lasts longer than 5 years, Brethauer told MedPage Today. For their study, Brethauer and colleagues assessed 217 patients with type 2 diabetes who underwent bariatric surgery at the Cleveland Clinic between 2004 and 2007. They were followed for a median of 6 years, with a range of 5 to 9 years. The majority had gastric bypass surgery, but some patients also had gastric banding or sleeve gastrectomy. Brethauer and colleagues found that remission -- including both partial a Continue reading >>
Life After Weight Loss Surgery: Can It Cure Type 2 Diabetes?
Three years ago, diabetes was just one of Carole Means' many health problems. At age 48, she weighed 515 pounds, and her heart was three times its normal size. Her blood glucose was in the 400s, she was on insulin and glucose-lowering pills, and her kidneys were failing. Yet her physical agony wasn't as painful as the emotional toll the weight took. In four years, she never saw her son play high school football, and she didn't attend his graduation. She rarely left her Des Moines home. Today, Carole spends two hours a day at a gym and loves to chase after her grandchildren. "I missed out on so much," she says wistfully. "But I'm making up for it now. My husband can barely keep me at home." Carole lost the bulk of her weight after undergoing surgery that reduced her stomach to the size of a golf ball. She had to make drastic, permanent changes in what and how she eats, but she says it's been worth it. She weighs about 130 pounds now and takes no diabetes medications. "My doctor says I no longer have diabetes," she says. "I know why I didn't die: I needed to stick around to share my story and inspire others to transition from hopeless to hopeful." Is Diabetes Remission Possible? While Carole's experience is not the norm, weight loss and the plummeting glucose levels that often follow bariatric surgery can be dramatic. Most people lose about 56 percent of their excess weight, with the range being 45-65 percent (66-110 pounds) based on data from the various surgeries during one to 10 years of follow-up. "The heavier you are, the longer it takes," says Margaret Furtado, RD, bariatric nutrition specialist at the University of Maryland Medical Center in Baltimore and author of The Complete Idiot's Guide to Eating Well After Weight Loss Surgery (Alpha, 2009). Men lose weight fa 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 >>
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 >>
Obesity Surgery Is A Good Way To Treat Diabetes, Groups Agree
International diabetes organizations are calling for weight-loss surgery to become a more routine treatment option for diabetes, even for some patients who are only mildly obese. Obesity and Type 2 diabetes are a deadly pair, and numerous studies show stomach-shrinking operations can dramatically improve diabetes. But Tuesday's guidelines mark the first time the surgery is recommended specifically as a diabetes treatment rather than as obesity treatment with a side benefit. They expand the number of eligible candidates. The recommendations were endorsed by the American Diabetes Association, the International Diabetes Federation and 43 other health groups, and published in the journal Diabetes Care. "We do not claim that surgery should be the first-line therapy," cautioned Dr. David E. Cummings, an endocrinologist at the University of Washington and senior author of the guidelines. But as standard care often isn't enough, "it's time for something new." About 26 million Americans have diabetes, mostly the Type 2 form where the body gradually loses the ability to produce or use insulin to turn food into energy. Many Type 2 diabetics, although not all, are overweight or obese. Many can control the disease with diet, exercise, medication or insulin — but years of poorly controlled diabetes can lead to heart attacks, strokes, kidney failure, amputations or blindness. Studies have long shown that most obese diabetics who undergo bariatric surgery see their blood sugar control dramatically improve. Some even reach normal levels despite quitting their regular medicine. The surgery is not considered a cure, because some people relapse. But others have remained in remission for years. Until now, health guidelines have focused on obesity surgery as a last-resort method for quick 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 >>
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 >>
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 >>