U of MN Study finds WLS ends type 2 diabetes (Henry Buchwald MD PhD)
University Of Minnesota / Study finds weight-loss surgery ends type 2 diabetes symptoms
U bases conclusion on 8,000 casesBy Jeremy Olson[email protected]Updated: 03/02/2009 11:17:11 PM CST Bariatric surgery is a virtual cure for type 2 diabetes, eliminating symptoms of the metabolic disorder in three of four patients, according to a University of Minnesota study released Tuesday. University researchers analyzed 621 existing studies, many of which already pointed to the ability of bariatric surgery to eliminate diabetes symptoms. When looking collectively at more than 8,000 diabetics in these studies, U researchers found that 78.1 percent had no symptoms of the disease after their weight-loss surgeries. Even among patients whose surgeries took place two years earlier, more than 74 percent reported no diabetes symptoms. The collection of these small studies in one large analysis makes a strong statement about the effectiveness of bariatric surgery, said Dr. Henry Buchwald, a U bariatric surgeon and lead author. The results, published in the American Journal of Medicine, suggest that bariatric surgery could be used more aggressively as a front-line treatment for diabetes, Buchwald said. "It's the best we have to offer today," he said. "That's a pretty strong statement." The U.S. has a growing epidemic of type 2 diabetes, in which the body either produces too little insulin, which regulates blood sugar, or becomes resistant to insulin's effects. Most diabetics inject themselves with synthetic insulin to manage the disease, which can be fatal if unmanaged and also can lead to heart and kidney problems. In rare cases, diabetics receive pancreas transplants. Bariatric surgery remains a controversial and costly approach to treating obesity. Most health plans approve the $15,000 to $25,000 procedures only for someone with a body-mass index of at least 40, or a BMI of 35 if they have related conditions such as diabetes. Some require people to fail at other weight-loss methods prior to the surgery. The number of inpatient obesity surgeries in Minnesota increased rapidly during the past decade but peaked at 4,779 in 2004, according to the Minnesota Hospital Association. There were 3,600 in 2007. The U analysis found certain types of surgeries were more effective at curbing diabetes. Only 57 percent of patients reported no diabetes symptoms after a banding procedure, in which an external band is tightened around the stomach to restrict food intake. More than 95 percent of patients reported no diabetes symptoms after a duodenal switch, a more complicated procedure that shrinks the size of the stomach and bypasses the duodenum, or first segment of the small intestine. Buchwald wouldn't call bariatric surgery a cure for diabetes, because the term implies that doctors know exactly how they are defeating a disease. In this case, doctors know that bariatric surgery works, but they don't yet know why. Buchwald said the findings offer new directions for diabetes researchers. Learning how bariatric surgery affects this disease ultimately could lead to a true cure. "Not only are we going to find out the mechanism of this therapy," Buchwald said, "but we may unlock what is really the basis of type 2 diabetes." Researchers from the Mayo Clinic, East Carolina University and United BioSource Corporation also participated in the analysis. Jeremy Olson can be reached at 651-228-5583.
Body by God; alterations by Buchwald. I love Jesus. I so so so appreciate my DS.
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