Doctors embrace bariatric surgery as effective treatment for diabetes

Fifty international scientific and medical experts have issued a "consensus statement" declaring that bariatric surgery should be considered a treatment option for patients with Type 2 diabetes, even if they are not extremely obese.

The new guidelines, published today online in the Annals of Surgery, urge surgeons performing bariatric surgery and healthcare insurers reimbursing for such treatment to relax criteria, adopted in 1991, that have restricted such surgery to patients with a body-mass index of 35 or more.

Reviewing more than a decade's worth of studies on weight-loss surgery and diabetes, clinicians and researchers backing the document have concluded that the improved metabolic function that is typical in diabetic patients who undergo bariatric surgery is not merely an incidental effect of weight loss. "Surgery is a specific treatment for diabetes...the effect on diabetes is a direct consequence of the new anatomy created by surgery," said lead author Dr. Francesco Rubino, director of the gastrointestinal metabolic surgery program at New York-Presbyterian Hospital/Weill Cornell Medical College.

The implications, added Rubino in an interview, "are enormous." For starters, that finding should drive a broadening of the patient population offered the option of gastric bypass surgery or less invasive procedures that reduce the capacity of the gastrointestinal tract. Rubino said that patients with Type 2 diabetes that is poorly managed by diet, exercise and medicine should now routinely be assessed as surgery candidates.

Some of those will likely be far less overweight than the bulk of patients who have had the surgery for weight loss. Rubino cited the example of diabetic patients of Asian descent, who rarely reach a BMI of 35 but who might benefit from bariatric surgery.

For the more than 20 million Americans -- and counting -- thought to have Type 2 diabetes, bariatric surgery may offer more than just another treatment option. Research shows that for many patients, diabetes abates dramatically and permanently with surgery. That, said Rubino, makes the possibility of a "cure"--a prospect not discussed until very recently--real for many patients who have been told that "living with diabetes" is the best they can do.

Beyond that, said Rubino, clinicians caring for these patients will need to optimize their pre- and post-operative care to serve a new objective: that of improving metabolic function. Currently, many bariatric surgery patients continue on diabetes medicines after their operation when that might not be optimal or even necessary.

Finally, the consensus finding should guide the search for drugs that can better treat Type 2 diabetes. Those should focus on how metabolic function is changed by an alteration of the gut's anatomy, and whether drugs could be developed or adapted to work in the same way, Rubino said.

-- Melissa Healy

Comments

[Luke Tunyich]

Medical establishment involved in weight loss surgery and diabetes researcher are admitting that the reason why diabetes abates dramatically and permanently with surgery is not understand.

The problem is that they think that they know why weight loss occurs after weight loss surgery.

I have proved that the weight loss induced by weight loss surgery is misunderstood as well as is the reason why diabetes type 2 abates after weight loss surgery.

The mechanism of weight loss induced by weight loss surgery is identical to the mechanism of involuntary weight loss induced by certain types of injury.
The mechanism underlining remission/cure of diabetes type 2 I have explained in the article “WEIGHT LOSS SURGERIES, DIABETES AND THE BIOMECHANICS OF SITTING AND WALKING”
The link to this article is http://diabetesandweightloss.googlepages.com/wls%26diabetes

Please take look in this article and if make sense to you please spreed the word. It will save people for surgery that is not based on understanding. Weight los surgery is the medical practice based on misunderstanding.

Luke Tunyich
http://www.biomechanicsandhealth.com/

[Bonnie]

There is a natural alternative to weight loss surgery. You can lose the weight without resorting to such drastic measures. When you are ready to take the first step towards working with a Christian weight loss counselor to end your battle with obesity and transform your life, please visit, http://bonniemechelle.com

[Linda Hibbard]

Try wearing wearable weights like “Body Togs” anatomically designed weighted sleeves worn on your arms & legs under your clothes. Put them on in the morning and you literally forget you have them on while increasing your calorie burn, muscle tone & bone density! Weighted vests work great too!

[RosaRosa]

Does the person Luke Tunyich [www.biomechanicsandhealth.com] really think intelligent readers will take someone who can not even spell seriously?

[jerry]

that's amazing. but I wonder what the consequences are. Is the "cure" for high blood glucose simply because less of it is absorbed through the small intestine? Or is it a real hormonal change that controls glucose. If it's the latter, that's a major breakthrough. If it's the former, than are important nutrients also being restricted from absorption.

[TK]

My own father lost his leg from diabetes and died of renal and heart failure.

One of my friends runs International Patient Facilitators. http://international-patient-facilitators.com/ Sheri Burke helps people recover their health with affordable options.

I've been a thin person most of my life. However, at my age my knees are not in any shape to take much cardio. Because of genes, I'm pretty sure I will not become obese. For those suffering with obesity and diabetes, sometimes bariatric surgery can save a life by offering a clean slate.