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Dialysis Discussion => Dialysis: News Articles => Topic started by: livecam on January 22, 2008, 06:36:33 PM
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Obesity operation may cure diabetes in many
Surgery patients 5 times more likely to see disease disappear, study says
CHICAGO - A new study gives the strongest evidence yet that obesity surgery can cure diabetes.
Patients who had surgery to reduce the size of their stomachs were five times more likely to see their diabetes disappear over the next two years than were patients who had standard diabetes care, according to Australian researchers.
Most of the surgery patients were able to stop taking diabetes drugs and achieve normal blood tests.
“It’s the best therapy for diabetes that we have today, and it’s very low risk,” said the study’s lead author, Dr. John Dixon of Monash University Medical School in Melbourne, Australia.
The patients had stomach band surgery, a procedure more common in Australia than in the United States, where gastric bypass surgery, or stomach stapling, predominates.
Gastric bypass is even more effective against diabetes, achieving remission in a matter of days or a month, said Dr. David Cummings, who wrote an accompanying editorial in the journal but was not involved in the study.
“We have traditionally considered diabetes to be a chronic, progressive disease,” said Cummings of the University of Washington in Seattle. “But these operations really do represent a realistic hope for curing most patients.”
Diabetes experts who read the study said surgery should be considered for some obese patients, but more research is needed to see how long results last and which patients benefit most. Surgery risks should be weighed against diabetes drug side effects and the long-term risks of diabetes itself, they said.
The diabetes benefits of weight-loss surgery were known, but the Australian study in Wednesday’s Journal of the American Medical Association is the first of its kind to compare diabetes in patients randomly assigned to surgery or standard care. Scientists consider randomized studies to yield the highest-quality evidence.
The study involved 55 patients, so experts will be looking for results of larger experiments under way.
'New way of thinking about diabetes'
“Few studies really qualify as being a landmark study. This one is,” said Dr. Philip Schauer, who was not involved in the Australian research but leads a Cleveland Clinic study that is recruiting 150 obese people with diabetes to compare two types of surgery and standard medical care.
“This opens an entirely new way of thinking about diabetes.”
Obesity is a major risk factor for diabetes, and researchers are furiously pursuing reasons for the link as rates for both climb. What’s known is that excess fat can cause the body’s normal response to insulin to go haywire. Researchers are investigating insulin-regulating hormones released by fat and the role of fatty acids in the blood.
In the Australian study, all the patients were obese and had been diagnosed with type 2 diabetes during the past two years. Their average age was 47. Half the patients underwent a type of surgery called laparoscopic gastric banding, where an adjustable silicone cuff is installed around the upper stomach, limiting how much a person can eat.
Both groups lost weight over two years; the surgery patients lost 46 pounds on average, while the standard-care patients lost an average of 3 pounds.
Blood tests showed diabetes remission in 22 of the 29 surgery patients after two years. In the standard-care group, only four of the 26 patients achieved that goal. The patients who lost the most weight were the most likely to eliminate their diabetes.
Both patient groups learned about low-fat, high-fiber diets and were encouraged to exercise. Both groups could meet with a health professional every six weeks for two years.
The death rate for stomach band surgery, which can cost $17,000 to $20,000, is about 1 in 1,000. There were only minor complications in the study. Stomach stapling has a 2 percent death rate and costs $20,000 to $30,000.
In the United States, surgeons perform more than 100,000 obesity surgeries each year.
The American Diabetes Association is interested in the findings. The group revises its recommendations each fall, taking new research into account.
“There is a growing body of evidence that bariatric surgery is an effective tool for managing diabetes,” said Dr. John Buse of the University of North Carolina School of Medicine in Chapel Hill, the association’s president for medicine and science.
“It’s just a question of how effective is it, for what spectrum of patients, over what period of time and at what cost? Not all those questions have been answered yet.”
Medical devices used in the study were provided by the manufacturers, but the companies had no say over the study’s design or its findings, Dixon said.
© 2008 The Associated Press.
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Gee ... didn't an IHD member post that there were few, if any, cures for illnesses?
Damn you medical researchers. Damn you!
8)
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Hard to call this a cure with so many factors to consider, plus it may not work for all. How long one has had diabetes, what types of complications has set in to name a couple. While Type 2 diabetics in some cases can control their diabetes through weight loss only, some still need to control theirs thru the use of oral medications, oral meds and insulin, and some with insulin only in small doses (different than type 1diabeties). Once you gain some weight back, you run a high risk of setting offthe effects of diabetes. P.T. Barnum comes to mind when I read this.
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If you want to go through life eating liquid diet and eating tiny portions, go ahead and do the surgery. I have seen people lose tremendous amounts of weight by watching what they eat.
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I had lost 95 lbs and my diabetes did not get any better in fact I ended up on insulin. I don't believe this article, but for those that want to believe it, go ahead because the weight loss is good for the rest of your health and definitely helps you get around easier. Unfortunately when I went on insulin I gained half of my weight loss back... dang it all. :shy;
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We have a good friend who is extremely obese. He's 6'3" or so and his top weight was over 400. I think he's currently around 375. He was diagnosed with diabetes a couple of months ago, and the doctor told him that if he would lose the weight, he would not have diabetes. Essentially, he has too much tissue for his pancreas to support. Cases like his would be the ideal candidates for the surgery, I would think, but I don't know enough about the processes involved in diabetes to know who else it could work for.