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:: Can Surgery Eliminate Diabetes?

Surgery for diabetesCan Surgery Eliminate Diabetes?

Traditionally Diabetes is considered a chronic, progressive disease with no known cure. However, a group of doctors and scientists led by Dr John Dixon of Monash University Medical School in Melbourne has conducted a research project that produced new data that suggests that obesity surgery can eliminate diabetes far more effectively than other treatments.

Obesity poses a primary risk factor for diabetes, and so losing weight is a major factor to controlling the disease. Patients in the non-surgical group lost weight by instituting lifestyle changes, but they didn't lose nearly as much as those who had the surgery.

Those who lost the most weight became diabetes-free the quickest. This is the key. It is the ability to lose the most weight that appears to make the difference. What surgery does is offer a quicker method of losing weight.

Diabetes and obesity - chicken or the eggObesity and Diabetes are a bit like the chicken and the egg. Which one do we treat first? It appears that if you treat obesity, diabetes is controlled; however, if you control your diabetes with a healthy lifestyle, weight loss should occur. So, like the chicken and the egg, the two go hand in hand. Most do not realise that obesity and diabetes are two manifestations of the same problem. Fix the cause of one and you fix the cause of the other.

We need to ask ourselves, what produces the best result?

  • Reducing stomach processing speed or capability 80% or
  • Putting 80% less sugar in your mouth

Whether you do it by dropping processed food and/or slowing eating or diluting the sugar digestion speed, should have the same effect as surgery. The statement below from Dr David Cummings should have people lining up for surgery!

"Most of the patients had stomach band surgery, but "gastric bypass is even more effective against diabetes, achieving remission in a matter of days or a month", said Dr. David Cummings

"We have traditionally considered diabetes to be a chronic, progressive disease," said Dr Cummings. "But these operations really do represent a realistic hope for curing most patients."

The study found that those Type 2 diabetes patients who had stomach-reducing operations were five times more likely to be diabetes free within two years than those who merely maintained a regimen of standard diabetes care.

Diabetes surgery studyOf the 55 patients in the study, 29 underwent obesity surgery, and of those, 22 tested negative for diabetes two years later. Of the 26 patients who didn't have the surgery, only four achieved similar remission.

In the study, all the patients were obese and had been diagnosed with Type 2 diabetes during the past two years. Their average age was 47. Half the patients underwent a type of surgery called laparoscopic gastric banding, where an adjustable silicone cuff is installed around the upper stomach, limiting how much a person can eat.

Both groups lost weight over two years; the surgery patients lost 23 kilos on average, while the standard-care patients lost an average of 2 kilos.

Both patient groups learned about low-fat, high-fibre diets and were encouraged to exercise. Both groups could meet with a health professional every six weeks for two years.

Blood tests showed diabetes remission in 22 of the 29 surgery patients after two years. In the standard-care group, only four of the 26 patients achieved that goal. The patients who lost the most weight were the most likely to eliminate their diabetes.

Before you rush out to book your surgery consider the following:

 

Don’t be misled. Any surgery has risks, but many who have tried everything else to lose weight and are unable to stop obesity progression, will accept the risk. Having diabetes disappear is a surprise benefit.

First, let's look at the surgical risk factor. The research subjects underwent a procedure called stomach banding, in which a silicone band gets implanted around the upper stomach, limiting how much food patients can eat. Stomach banding incurs a fatality rate of one per 1000 operations.

The death rate for stomach band surgery, which can cost $17,000 to $20,000, is about 1 in 1,000. There were only minor complications in the study. Stomach stapling has a 2 percent death rate and costs $20,000 to $30,000.

Potential complications (other than dying) include severe mal-absorption of nutrients, malnutrition, bleeding, infection, anaemia, gallstones, unstoppable vomiting, and so on.

In older patients who undergo surgery, the risk factors are greater. Given that Type 2 diabetes patients fall into the “older” category the risks are worth considering.

The bottom line is that bypass surgery puts you at considerable risk, particularly if you're over 50, and still leaves you vulnerable to diabetes damage. As with most other health issues, you need to take a systemic approach - not a magic bullet.
 

 ►

Also consider that for all the risk, the surgery doesn't last. Many patients experience disintegration of the bypass modifications over time. The stomach pouch stretches back to its original size, stomach contents leak into the abdomen. When these things occur, the operation must be reversed. What happens to the diabetes risk factor then?

Diabetes experts who read the study said surgery should be considered for some obese patients, but more research is needed to see how long results last and which patients benefit most. Surgery risks should be weighed against diabetes drug side effects and the long-term risks of diabetes itself, they said
 

 ► Consider the size of the research group.  The study involved 55 patients, so experts will be looking for results of larger experiments under way.

What the research does though is open up an entirely new way of thinking about diabetes.  Some questions that still need to be answered over time are:

  • How effective is surgery?
  • What patients is surgery the most effective method for, and
  • Over what time and
  • What cost?

Not all those questions have been answered yet.  Watch for further results.

In the meantime, consult your doctor for more information, and don't forget to Ask Your Pharmacist to help with your diabetes management.

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