Possible Cure for "Diabesity"
New research released Monday offers evidence that weight-loss surgery can reverse and potentially cure diabetes.
The reports, released in the New England Journal of Medicine in conjunction with the American College of Cardiology Conference in Chicago cite two studies. Two studies, conducted at the Cleveland Clinic and the Catholic University in Rome, compare stomach-reducing operations to medicines alone as treatment for "diabesity," or Type 2 diabetes brought on by obesity.
More than a third of American adults are obese and more than eight percent have diabetes. These millions of Americans who are affected by "diabesity" may greatly benefit from this new evidence.
In both studies, surgery helped to reduce patients' blood-sugar to normal levels rather than medicinal treatment. Some patients were able to stop taking insulin as little as three days after their operations, and many were able to stop all diabetes drugs and have their disease stay in remission for at least two years.
However, those treated with solely medicine did not experience such significant results.
Dr. John Buse of the University of North Carolina at Chapel Hill did not participate in the studies but called the new research, "a major advance." Buse said he recommends weight-loss surgery to patients who are obese and can't control their blood sugar through medications.
The Chief of Diabetes Surgery at New York-Presbyterian Hospital, Francesco Rubino, stated that the surgery has proven to be a very appropriate and excellent treatment for diabetes.
As one of the study co-leaders, Rubino believes that the most proper name for the surgery is "diabetes surgery." Diabetics or individuals with heart disease with a body mass index of at least 30 are eligible for the gastric band surgery.
Many of the medicines that doctors have typically used for the past century to treat diabetes can cause weight gain, worsening the disease.
The results of these new studies may offer hope for a long-term fix. Gastric Bypass or "keyhole" weight-loss surgery, in which doctors reduce the stomach to a small pouch and reconnect it to the small intestine, seemed to be the most common type. Stomach banding surgery, however, only served to lower blood sugar without reversing the disease.
The Cleveland Clinic study, sponsored by an obesity surgery equipment company and conducted by Dr. Philip Schauer, involved researching 150 people given one of two types of surgery plus standard medicines or a third group given medicines alone. These individuals had A1C blood sugar levels over nine on average, while a healthy A1C measure is six or below. Individuals are considered to have diabetes at an A1C of 6.5.
One year after treatment began, just 12 percent of patients treated with medicines alone were at a healthy A1C level, versus 42 percent and 37 percent of the two groups given surgery. Medicinal treatment alone led to higher cholesterol and higher heart risks as well.
The Catholic University in Rome study, led by Dr. Geltrude Mingrone, involved 60 patients given one of two types of surgery or medicines alone. Two years later, 95 percent and 75 percent of the two surgery groups maintained target blood-sugar levels without diabetes drugs, while none of those treated with medicine alone did. None of the patients involved in the study died as a result of the surgery and there were few complications. Doctors note that these health complications can result from uncontrolled diabetes as well, however.
Some doctors believe that the surgery may positively affect the patients' insulin-producing hormones to reverse diabetes.
Several patients like Jon Diat and Tamikka McCray offer their success stories as individuals who suffered from "diabesity" and who now have normal blood-sugar levels as a result of their surgeries. Both have seen their diabetes disappear without the help of medication.
Director of the Vanderbilt University Diabetes Center Dr. Alvin Powers said that while "we still don't know the long-term outcomes of these surgeries and whether the benefits will last for more than a few years, the results are very encouraging for people like those in these studies."
Many doctors stress that the surgery should not be seen as a last resort, and should be considered earlier in treating obese people with diabetes.