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Weight-Loss Surgery Reverses Diabetes For Obese Patients


 "Diabesity" -- Type 2 diabetes brought on by obesity -- can be reversed by stomach-reducing surgery like gastric bypass and researchers say the operation should be offered sooner to obese and overweight patients instead of as a last resort.

Two new studies, one at the Cleveland Clinic, the other at Catholic University in Rome, are among the first to compare the effectiveness of two types of bariatric surgery  with traditional medicine in controlling Type 2 diabetes.

Both studies found that surgery was far more effective at helping obese people achieve normal blood-sugar levels than just medicine alone.

In the Cleveland study, involving 150 patients, 42 percent and 37 percent of the two surgical groups saw their diabetes go into complete remission, compared to just 12 percent of those treated with medicines.

In the Italian study of 60 patients, 95 percent and 75 percent of the two surgery groups needed no diabetic drugs to keep their blood sugar levels normal after two years, while none in the medicine-only group did.

Unquestionably, the results were dramatic. After the surgery, some people were able to stop taking insulin to control their blood sugar as soon as three days after their operation. Cholesterol, blood pressure and other heart risk factors also were greatly improved.

It also appeared that restricting the gastric tract -- and not just weight loss -- caused the immediate effect on patients' blood sugar and hormone levels, study co-author Sangeeta Kashyap told  USA Today. She noted that overweight people often stop making important hormones that help regulate insulin.

"We used to think the pancreas was dead" when people with Type 2 diabetes had to start taking insulin, Kashyap said. But the surgery caused the pancreas to start working again. "Their pancreas was waking up and revitalized."

However, Vivian Fonseca, M.D., president for medicine and science with the American Diabetes Association, was more cautious, cautioning that both studies were small and "not game changers," as he told the  New York Times.

In the U.S., more than a third of Americans are obese and between 5 and 10 million Americans are both obese and suffer from Type 2 diabetes, which is linked to age, weight and family history. If uncontrolled, diabetes can lead to devastating complications including amputation, kidney failure, blindness and heart disease.

Surgeons and obesity experts -- not to mention the makers of the equipment used for bariatric surgery -- are all very interested in establishing surgery as a way to treat diabetes, as well as obesity.

In fact, the Cleveland Clinic study was sponsored in part by a bariatric surgery equipment company and some of the researchers had been paid consultants. The federal government also contributed funding for the research.

Gastric bypass surgery can cost up to $25,000. Medicare covers it for treatment of diabetes in those who are extremely obese, but not all private insurance plans do.

In other health news:

A heart transplant at 71? Is Dick Cheney part of a trend? The former vice president got a new heart -- is that unusual for a man his age? The short answer, says the L.A. Times, is: less unusual than it used to be. The majority of heart transplants last year went to patients age 50 to 64, but 14 percent went to patients age 65 and older -- up from 3.4 percent in 1990.

Chocolate lovers tend to weigh less. People who ate a small amount of chocolate a few times a week weighed less than those who rarely indulged, according to a new U.S. study involving 1,000 people. Researchers weren't quite sure why this was the case, Reuters reports, but one theory is that "people who lost weight rewarded themselves with chocolate."

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