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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..
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I applaud the budget, even though Health Care and education may stay unscathed. Sadly this cannot last and I worry to later this year where cuts will become enviable. If anything, this provides the Wildrose Alliance plenty of ammo when an election is called.




Comments are now closed for this story
Jamie Bee
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Kim in Newcastle,ON
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Vince Jensen
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Ginny C
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PB
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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
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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
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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
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j d
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MB in Alberta
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Maureen
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iainr
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Edee N - Ottawa
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Nancy Rourke
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Woody
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Jackie T
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Sid in MTL
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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
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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
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S crump
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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?