Monday, May 19, 2008

Doctor recommends gastric bypass as way to prevent diabetes

New York, NY

Research shows weight loss surgery may be able to completely reverse Type 2 diabetes, as close to 90 percent of those with the disease are overweight, but the numbers of people getting the surgery are still small. NY1 Health & Fitness reporter Kafi Drexel has more on why this may be and what doctors are hoping can be done about it.
Before undergoing gastric bypass surgery, Judy Grant, 58, was 306 pounds and suffered from Type 2 diabetes. Now a year later, she's more than 100 pounds lighter and all signs of Type 2 are gone.

"I wasn't insulin dependent yet, but that was coming," she said. "And I knew that I was quickly approaching that because I was just having so much trouble and it took so much to manage me and I was thinking, 'If I continue on, where will I be?'"

Obesity is a leading cause of Type 2 diabetes. Doctors say weight loss surgery, also known as bariatric surgery, works because it leads to long-term weight loss, which helps lower blood sugar levels. Some of the latest research shows that diabetes goes away in many patients who undergo gastric bypass even before they start losing significant amounts of weight.

"In more than 434 patients who underwent gastric bypass, 89 percent of those have completely eliminated diabetes," said Dr. Piotr Gorecki. "We still call it suppression, rather than a cure, because still certain factors may be important there. But for practical reasons, they do not take their medicine, their glucose levels are normal, and they do not have any other features of diabetes as a disease."

Gorecki points out even those patients who are not "cured" so-to-speak are seeing significant improvements.

Despite the successes, there are still relatively few people undergoing the procedure. Guidelines from the National Institutes of Health, written nearly two decades ago, say only the morbidly obese should be eligible, possibly putting up roadblocks for potentially millions of mildly obese patients who could benefit.

Doctors, like Gorecki, who see the benefits in patients say it is time those guidelines start to be re-evaluated.

"Since both of these diseases, obesity and diabetes, are so prevalent and are so epidemic on such a large scale, this will be a major issue for insurance companies, for all third-party payers, including the government, for medical and surgical societies to come up with new guidelines," he said.

But with no plans in the works to revise guidelines, doctors or patients will probably not see any change to guidelines overnight. They say the hope is that continued evidence pointing to improved health benefits will change the outlook.

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