Weight-Loss Surgery Can Reverse Diabetes


The case of a 12-year-old Texas girl who had weight loss surgery attracted national attention. The girl had developed a benign brain tumor a few years ago, but upon removal her metabolism went haywire and she her weight skyrocketed to over 200 pounds. She had sleeve gastrectomy surgery to remove 80 percent of her stomach, which immediately reversed her diabetes by affecting her glucose metabolism, or the process of converting sugar into energy for cells to use.  While hers might seem like a rare situation, doctors have found that weight-loss surgery does more than shed pounds; it can reverse patients’ type 2 diabetes.

Cleveland Clinic researchers presented results at the American College of Cardiology annual meeting in Washington, D.C. today from a study that showed stomach-reducing operations are more effective than medications for treating “diabesity,” the unhealthy combination of obesity and Type 2 diabetes. Published in the new issue of The New England Journal of Medicine, the study showed that the majority of patients who underwent surgery no longer needed insulin and other diabetes medications three years post-surgery. The diabetes-controlling success rate depended on the type of weight-loss surgery, but surpassed non-surgical treatment.

The researchers followed 150 people with type 2 diabetes. The average participant age was 49 and two-thirds were female. When the study began, the participants’ average body-mass index (BMI), which serves as an estimate of a person’s body fat, was almost 37. Per the U.S. Centers for Disease Control and Prevention, anything over 30 is considered obese and below 25 is considered normal.

The researchers randomly divided the study participants into three groups: those who received standard medicinal management for their type 2 diabetes, those who received gastric-bypass surgery and those who received a sleeve gastrectomy.

Three years after surgery, more than 90 percent of the patients who underwent bariatric surgery lost 25 percent of their body weight and could control their diabetes without insulin use or multiple diabetes drugs, according to the researchers. More participants in the gastric bypass group could control their blood sugar without diabetes medication compared to those in the other groups. However, the sleeve gastrectomy group had better results with their blood sugar than the patients in the medication group. Blood-sugar levels were down to normal in 38 percent and 25 percent of two groups given surgery, but for only 5 percent of those solely treated with medication. Even those participants who did not reverse their type 2 diabetes completely, weight-loss surgery still helped them reduce their medication levels needed to control their blood sugar, according to the study.

The doctors involved with the study are not sure how the surgery produces the benefits. One theory is that the gut releases hormones to spur insulin, and trimming away part of it affects the hormones and the patients’ metabolism.

Diabetes causes heart disease, kidney failure, strokes, vision trouble and other serious health problems. Type 2 diabetes causes the body to inefficiently use insulin, a hormone that helps get sugar from blood into body cells as fuel. When cells become insulin resistant, that fuel builds up in the blood instead of cells. The high blood sugar levels are what creates health complications over time.

An estimated 26 million Americans have diabetes. Of them, two-thirds are overweight or obese. Besides drug and insulin treatments, doctors urge weight loss and exercise, but few patients drop enough pounds to make a difference. This new study shows that weight-loss surgery can be an effective treatment option to reverse diabetes as it showed for the Texas tween and the patients in the Cleveland study.

By Dyanne Weiss

Wed MD
NBC News


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