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.

Just thought I'd do an overdue update on me.    I first had a VBG (stomach stapling) back in /87 in Toronto, Canada.   The first two years were great and I went from 260 lbs. down to 113 lbs.    Of course back then we were basically given no aftercare support, told take a daily kid's Flintstone vitamin and don't overeat or it will cause pain.  (Plus my then surgeon later lost his license for several years due to abuse (but that's another story)   so no follow up when I started having trouble.

Well I still managed to keep my weight down but only by dieting after the first three years or so.  Like most other wls patients back then I didn't deal with the emotional reasons I had turned to self medicating with food.    Back then the way the staples were done almost always led to them separating thus causing me to want to overeat again.  I'd start stuffing myself and get the heart attack like pain and have to throw up.  My weight slowly crept up to 160 lbs. and I dieted back down to 113 lbs.

Finally by /96, I had remarried and during 6 mths. of bedrest with the "pregnancy from hell"  I started to pig out from stress and delivered my baby weighing 207 lbs.  By the time /06 came around I felt like a total failure and weighed 251 lbs.    Then I heard from my family doctor about a surgeon who was doing lap-band surgery but in Ontario where I live the only wls covered by our provincial government was RNY & DS.   A few weeks later I decided what the heck I would go see this surgeon and see if he could help me.    I was prepared for him to tell me I was beyond saving and just a loser (not the kind I wanted to be though .)

Instead he said after looking at my past surgery papers I had brought that he would need to run tests but that I was a good candidate for a revision to the band.   The surgery would cost $16,000 but included lifetime fills for no additional charge and if ever I had complications or needed a new band there would be absolutely no additional cost to me as it was all under warranty for life.   It was a lot of money but I decided to go for it with my husband's support and I am so glad I did.     I was banded on April 18th,/06, and weighed 251 lbs. day of surgery and was able to reach my goal weight of 124 lbs. at twenty months out.    Since then I have stayed at or below goal fluctuating between 117.6 lbs. to 124 lbs.

In almost three years I have had no problems, can eat most everything except what I had trouble eating from the VBG (some staples were still intact) such as more than a small bit of rice, dense meat, etc.   Also I've only thrown up a total of 3 times and being diligent with fills when I've needed them has kept me satisfied with eating a small portion of foods like dessert, etc. that I previously would of binged on.

My advice to others considering a revision is to research all your options, and go for consults with surgeons that are experts at doing revisions and have wonderful aftercare support.  I myself didn't need the extra of malabsorption that the DS or RNY offered but certainly I have met at support groups others who did just as well as myself with these surgeries.   Everyone is different and I strongly believe that there is no one perfect surgery but research the type that fits you best that will offer you maximum results.   Also be realistic and educate yourself on possible complications that can occur with all of the surgeries be they be lap-band, vsg, rny or ds.

Wishing every one success, if I could do it anyone can.  Believe me by the time I had my revision I was like a train wreck waiting to happen and not able to diet more than half a day before derailing.  Now I've gone from a BMI of about 47 to 22 roughly and feel great.  Also I can't emphasize enough the benefit of joining support groups.   I belong to several for people who have had any type of wls and I also started up a support group for bandsters that I facilitate, it really makes a difference!

Hi Dawn,

I had a VBG back in /87, went from 260 lbs. down to 113 lbs. by /96 after a 7 month bedrest pregnancy from hell lol I was up by /06 to 251 lbs.    I had a revision to the Lap-band and went down to my goal weight of 124 lbs in twenty months with no problems.   Research your options well and if you do go with a band expect to need patience until you have enough fills to reach good restriction to succeed.   Only go with a clinic that offers extensive aftercare in order to have great results.

Thanks for the info. I am going now to check it out.

I must agree with Christina,  the stories have been quite scary on this site in regards to the VBG precedure and yet I had the precedure done almost a yr ago(Mar 18th).   I am very, very pleased with my weight loss but most importantly getting rid of ALL medications!!!!   I take one multi-vitamin a day and THAT IS IT!!!!    Unreal!
 Also, with this VBG I had a sleeve.    It is done much differently than back in the "80's".    With any precedure you can have problems.    But this is very "safe' and it is very consistant with losing.    I feel completely wonderful and since my precedure in my area have been MANY others that have stepped up to the plate and had this same precedure with again AMAZING results.    I cannot say enough "good things" about this precedure.     It is very healthy and SAFE..........and the best part is my intestines are RIGHT WHERE THEY ARE SUPPOSED TO BE unlike the RNY and DS.    Everything travels down and out just like it did before surgery, only exception is that it is much smaller capacity for this to happen.............gotta love them sleeves!!!!!   HOpe this helps anyone out there that is considering this precedure but is afraid...........IT WORKS!!!!!