CTV News | Obesity surgery may be long-term diabetes solution

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Obesity surgery may be long-term diabetes solution

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CTV.ca News Staff

Date: Wed. Jun. 24 2009 2:32 PM ET

New research is revealing that obesity surgery does more than simply help patients lose weight; it may also "cure" type 2 diabetes for five years or longer.

In two new studies presented at the annual meeting of the American Society for Metabolic and Bariatric Surgery, researchers have found that both "lap band surgery" and gastric bypass surgery can help eliminate diabetes.

While previous studies have made similar findings, this new research finds that the effects can be long-lasting.

In one study, researchers at New York University School of Medicine looked at 95 morbidly obese patients, with an average BMI (body mass index) of 46, who underwent a temporary form of stomach reduction, called laparoscopic adjustable gastric banding (LAGB).

Five years after the surgery, diabetes in 40 per cent of patients had gone into remission so that they could stop taking medication. An additional 43 per cent of patients saw their diabetes improved so that their blood sugar levels fell and they could reduce their medication use.

"Our study contributes to mounting evidence that demonstrates gastric banding can have a sustained and meaningful effect on diabetes and morbid obesity and that the two diseases are interrelated," said Dr. Christine Ren, co-researcher and associate professor of Surgery at New York University School of Medicine.

Ren noted that those patients who had diabetes for the least amount of time before surgery tended to be more likely to see their condition go into remission.

"We didn't find a substantial difference in remission outcomes for patients who suffered with diabetes for more than six years compared to those who had the disease for a shorter period of time," said Ren.

A second study of 177 obese patients with diabetes who underwent gastric bypass surgery, or stomach stapling, as it's sometimes called, found that 57 per cent of those remained diabetes-free up to 16 years after the procedure.

Once again, those most likely to experience a recurrence of diabetes were those who had type 2 diabetes longer prior to surgery and who had a more severe form in which they were dependent on insulin.

Those who saw their diabetes return were also those who regained the most weight following the surgery.

Study co-author, Dr. James W. Maher, professor of Surgery at Virginia Commonwealth University said these two factors seem to be the primary determinants of long-term diabetes resolution after gastric bypass surgery.

"This study suggests that people with Type 2 diabetes and morbid obesity who get surgery before becoming insulin-dependent have the greatest chance for complete resolution and avoiding the progression of diabetes."

In gastric bypass surgery, the stomach is reduced from the size of a football to golf-ball-size. As well, the upper portion of the small intestine is replaced with the lower part.

Stomach banding, or LABG, involves wrapping a silicone band around the upper part of the stomach to limit the amount of food it can hold.

People who are morbidly obese are generally 100 or more pounds overweight and have a BMI of 40 or more. They also meet the definition if they have a BMI of 35 or more with an obesity-related disease, such as Type 2 diabetes, heart disease or sleep apnea.

The American Diabetes Association recently recommended bariatric surgery be considered for adults with BMI greater than 35 and type 2 diabetes, especially if the diabetes is difficult to control.

Consensus is building in Canada that surgery, not medications, may be the more effective and even more cost-effective solution for obese people with difficult-to-control diabetes, said Dr. Mehran Anvari, a surgeon at St. Joseph's Healthcare in Hamilton, who has also studied the surgery's health benefits

"Type 2 diabetes is not a benign disease and many patients experience significant complications from diabetes that may be worse than potential complications from surgery," he told CTV News.

There are at least a dozen hospitals across Canada that offer bariatric surgery for those with morbid obesity, but the wait for the surgery can stretch five years or longer. Lap band surgery is also available at private clinics across Canada though the costs are not covered by provincial or regional health plans..

Comments are now closed for this story

Jamie Bee
said
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Are you kidding me.The solution is very simple without being hacked open and costing tax payers.Its not rocket science.NO BREAD,NO PASTA,NO CEREALS,NO GRAINS,NO POTATOES,NO JUNK,NO FAST FOOD,NO CANDY AND NO MELONS.I was borderline diabetic and I reversed it and lost weight.Its a matter of shutting your mouth.Is this nation so addicted to garbage food that we need to have surgery.Unbelievable.I know people who are type 2 diabetics ,they dont eat right.If they were eating right it would be a non-issue.These surgeries are completely unnecessary.If someone is eating right and they can prove it and they are still having issues with blood sugar levels then I can see it.Otherwise,I'm sorry but its a matter of watching what you eat.



Kim in Newcastle,ON
said
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I am living proof of this. I had diabetes for 9 years, was insulin dependant and had a BMI of 48 when I had RNY gastric bypass last September/08. In three weeks I was completely off insulin and now I have perfectly normal blood sugars and take no meds whatsoever for diabetes, hypertension or high cholesteral. It's been like a miracle cure and in 9 months I've lost 94 pounds.


Vince Jensen
said
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Congratulations on your success Jaimie Bee. You should be proud to be part of the 1% of diabetes patients that is able to achieve these results. Unfortunately the other 99%, of which I am a member, are not so fortunate, dedicated, obsessive, whatever it takes, to be successful in our efforts. Does this mean that I should be required to pay the excessive drug and monitoring costs associated with diabetes? Does it mean that I have to be one of the group that risks limb amputations, kidney failure, blindness, and heart disease because I am not as good/fortunate as you?


Ginny C
said
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More education and at a younger age and the eliminating of the availability of junk & fast food and more preventative medicine is what is needed. I agree with Jamie B - if the above does not do the trick - then surgery. If we start with education on over all wellness & start treating the root of health care problems not just the symptoms - our health care system would be in alot better shape and so would our population


PB
said
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How about this for cost-effective: Start moving and stop eating sugar and procressed foods! And everyone wins!

I get that this can help some people, but just as this article states in the beginning (a "cure" for type 2 diabetes for 5 years or longer), it's no long-term solution for most. Don't be sucked into what the food industries are pushing onto you, get rid of the addiction to bads "foods" and get moving! It's not rocket science!






LB
said
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Jamie Bee is right on.

God forbid we have to make a diet change for our health.

My mom is diabetic but is managing with diet changes and exercise.

On the other hand, another relative is diabetic and more then happy to pop 4 pills a day (that insurance covers) rather then change his horrible, massive portion diet and as for exercise--what's that?

I was gestational diabetic, so I do know what diet change is like and how hard it is.


CMT
said
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Being border line does not make you a diabetic it mean that you are capable of contracting the disease.

Congrats on your success however like Vince has said if this is the long term solution to the cure for diabetes then lets get on it!!!! I too am diabetic and insulin dependent ... I am fighting genetics for body weight etc.

Don't tell me that I need to stop eating starchy food...because as any DIABETIC knows we need the carbs or we will fall into a shock.

So kudos to you but you are only the 1% lets give the other 99% a fighting chance!




Elisse in Ottawa
said
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6 years after gastric bypass surgery and my blood sugar levels are absolutely normal, when I was non-insulin dependent diabetic beforehand. And just because you get surgery , doesn't mean you don't have to watch your diet - I think I watch what I eat more than 95 percent of the people I know... it IS POSSIBLE to make yourself obese again after gastric bypass. It's a tool, not a cure!


j d
said
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Certainly not everyone needs surgery, but sometimes it's mentally, physically and emotionally necessary to help lose the weight....once it's lost, then people can make wiser choices because they are feeling better. Now we need more doctors to actually DO the surgery! Waiting list is way too long! And far too expensive to get it privately.


MB in Alberta
said
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It is uneducated comments like the ones on this board that made me feel like it was my fault I'm diabetic and made the diagnosis extremely difficult to come to terms with. I have type 2 diabetes, I eat healthy (which by the way DOES include a small amount of carbs), I exercise and am at a healthy body weight, yet I still require 8 pills a day to regulate my blood sugar. Have you people never heard of the concept of genetics ???


Maureen
said
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Please everyone, there are so many factors that contribute to hunger and food craving that simplistic views of just shutting one's mouth and not eating are not helpful. Just think of being deprived of air to breathe and you might understand.


iainr
said
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People, there's good carbs and bad, Low glycemic the better, and that's the point, a balanced diet based on all food, I understand protein is very important to one, but don't go all protein, that's unhealthy also,count your calories and eat healthy is all your body wants.


Edee N - Ottawa
said
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I would love for all Canadians to be able to have access to a exercise facility or that nutritionists would be covered by health care. I think that this would be a way that would help obese people have other options than being cut open and have a band around their stomachs.


Nancy Rourke
said
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So does OHIP cover this if I get it done ??? heheheheee. I wish !!!!!!!!!


Woody
said
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Congrats Jamie Bee but cutting out all carbs is not necessary. Everything in moderation, exercise, understanding what you're putting in you and sometimes support from others in the same situation is the solution. We run support groups for diabetics and 2 people have changed their lifestyle and are medication free. They've learned to LIVE a full life with diabetes. Sadly, throw in genetics and regardless of weight or BMI you're more likely to become diabetic. Thems the breaks!


Jackie T
said
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I am always truly amazed as to the ignorance of some people!Jaimie Bee...godbless you for your abilities!!But for others, lots of others,wls surgery is the ONLY way to successfully treat 1.diabetes 2.morbid obesity. But it's just easier for society to say that you don't have enough will power to overcome both of these diseases.


Sid in MTL
said
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Wish I could live in your world, Jamie Bee! This is not as cut and dried as you might think. Type II diabetes, though unfortunately usually always considered a disease of the obese, is so very wrong.

A good friend of mine is morbidly obese and has been for nearly all of her 52 years, but does not have diabetes, hypertension, nor high cholesterol/triglycerides.

I, on the other hand, have type II diabetes, hypertension, and high cholesterol/triglycerides despite the fact that I have always been a strict vegetarian, am in fact slightly under-weight and am physically active.

I need medication to control my glucose levels and no amount of bariatric surgery is going to do ding dong for me.

So you see J.B., et al, In my case, and in the case of so many others, we inherited the disease(an uncle on my father's side and my mother had type II diabetes) and there's not a damn thing we can do about it.

That, as they say, is life.


From BC
said
0 0

It's a misconception that everyone who is diabetic is overweight.
My brother contracted diabetes when he was 19 years old (more than 30 years ago). He was far from obese (the opposite in fact) and to this day he is not overweight. His diet was no different from anyone else, plus we always got a lot of exercise. I'll agree that weight is a factor and it can obviously bring diabetes on. I'm just saying the statements about weight, diet and exercise are misplaced and not the whole story.
But what do you expect; the medical community as a whole seems to have the same attitude and expect to see a family of fat people if I tell them my brother is a diabetic.


Brad Majors
said
0 0

Jamie Bee has it right. I see the TV ads for Bypass surgery with the slogan, "Say yes to yourself!". Unfortunately, it was saying yes to yourself too often that got you in the place where surgery is needed. I'm a Type 1, diagnosed at the age of 48, and I gave up pop, fast food, baked goods, etc. I also excercise regularly to assist in controlling my glucose levels. Not only am I much better off blood-sugar wise, I am fitter and healthier than I've been in years. To use surgery for weight control, when so many people wait so long for life-saving procedures, is a poor use of limited medical facilities. Self-discipline and moderation are the answer, even if it is difficult and slow.


S crump
said
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Those making comments should get their facts straight, Lap band surgery is NOT covered by Medicare. You have to pay out of your own pocket. Gastric Bypass is covered. This is completely unfair. The health benefits are there and if I want to spend my hard earned dollars on my health, I should bloody well be able to do so. And I have! I have lost weight, reduced medication and feel better. I still have a long way to go,

It would be useful if those who tell me all I have to do is stop eating or eat right would walk a mile in my shoes and see how hard it is when you weight twice what you should. Besides I spent my own money. Also is a reach to think that maybe my problem with overeating is in the genes or as some have suggested an addiction just like smoking. If the smoker can haves government paid lung surgery then why can't I have government funded Lab Band Surgery?

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