Gastric bypass surgery resolves diabetes in teens

Teenagers who undergo gastric bypass surgery are often immediately relieved of Type 2 diabetes, according to research published today in the journal Pediatrics.

Studies on adults with Type 2 diabetes show that gastric bypass can result in disease remission or better disease control. However, this study is the first to explore the effects of the surgery in children. The study examined adolescents with Type 2 diabetes, which is usually related to obesity and is being diagnosed with alarming frequency in American children and teenagers.

Dr. Thomas Inge, director of the Cincinnati Children's Surgical Weight Loss Program for Teens, studied 11 extremely obese teens with Type 2 diabetes who had gastric bypass surgery and 67 obese teens who were receiving medical management for Type 2 diabetes. Among the 11 teens who underwent surgery, all but one had a remission in diabetes. The response was so rapid, the patients often discontinued medication for diabetes control before leaving the hospital after surgery. These teens lost an average of 34% of their body weight one year after surgery. In contrast, the teens who were medically managed did not have any weight change after one year and were all still taking medication for diabetes. The adolescents who had surgery also had improvements in blood pressure, cholesterol and triglyceride levels.

"The results have been quite dramatic and to our knowledge, there are no other anti-diabetic therapies that result in more effective and long-term control than that seen with bariatric surgery," Inge said in a news release.

Inge and his co-authors noted that future studies will be needed to track the long-term health of teenagers who participated in the study. Cincinnati Children's Hospital is home to a study funded by the National Institutes of Health that will collect and report outcomes on 200 teens undergoing weight-loss surgery nationwide.

-- Shari Roan

Photo: Amanda Munson is among the participants in Cincinnati Children's study on gastric bypass surgery. Credit: Ernest Coleman / Cincinnati Enquirer

Comments

[Dan]

Thoughts about Obesity

Obesity is when excess body fat accumulates in one to where this overgrowth makes the person unhealthy to varying degrees. Obesity is different than being overweight, as it is of a more serious concern. As measured by one’s body mass index (BMI), one’s BMI of 25 to 30 kg/m is considered overweight. If their BMI is 30 to 35 kg/m, they are class I obese, 35 to 40 BMI would be class II obese, and any BMI above 40 is class III obesity. Presently, with obesity affecting children progressively more, the issue of obesity has become a serious public health concern.
Approximately half of all children under the age of 12 are either obese are overweight. About twenty percent of children ages 2 to 5 years old are either obese are overweight. Worldwide, nearly one and a half billion people are either obese or overweight. In the United States, about one third of adults are either obese or overweight. It is now predicted that, for the first time in about 150 years, our life expectancy is suppose to decline.
Morbid obesity is defined as one who has a body mass index of 30 kg/m or greater, and this surgery, along with the three other types of surgery for morbid obesity, should be considered a last resort after all other methods to reduce the patient’s weight have chronically failed. Morbid obesity greatly affects the health of the patient in a very negative way. It has about 10 co-morbidities that can develop if the situation is not corrected. Some if not most of these co-morbidities are life-threatening.
One solution beneficial in many cases of morbid obesity if one’s obesity is not eventually controlled or corrected is what is known as gastric bypass surgery. This is a type of bariatric surgery that essentially reduces the volume of the human stomach in order to correct and treat morbid obesity by surgical re-construction of the stomach and small intestine. Patients for such surgeries are those with a BMI of greater than 40, or a BMI greater than 35 if the patient has comorbidities aside from obesity. This surgery should be considered for the severely obese when other treatment options have failed.
There are three surgical variations of gastric bypass surgery, and one is chosen by the surgeon based on their experience and success from the variation they will utilize. Generally, these surgeries are either gastric restrictive operations or malabsorptive operations. Over 200,000 gastric bypass surgeries are performed each year, and this surgery being performed continues to progress as a suitable option for the morbidly obese. There is evidence that this surgery is particularly beneficial for those obese patients that have non-insulin dependent Diabetes Mellitus as well.
So the surgery to correct morbid obesity greatly limits or prevents such co-morbidities associated with those who are obese. Two percent of those who undergo this surgery die as a result from about a half a dozen complications that could occur. However, the surgery reduces the overall mortality of the patient by 40 percent or so, yet this percentage is debatable due to conflicting clinical studies.
Age of the patient should be taken into consideration, as to whether or not the risks of this surgery outweigh any potential benefits for the patient who may have existing co-morbidities that have already caused physiological damage to the patient. Also what should be determined by the surgeon is the amount of safety, effectiveness, and rationale for a particular patient regarding those patients who are elderly, for example.
Many feel bariatric surgery such as this should be considered as a last resort when exercise and diet have failed for a great length of time.
If a person or a doctor is considering this type of surgery, there is a website dedicated to bariatric surgery, which is: www.asmbs.org,

Dan Abshear

________________________________________