25th May 2014
Will weight loss surgery ‘cure’ diabetes?
It did seem to be too good to be true when the ’60 Minutes’ TV programme reported in 2008 that weight loss surgery could put type 2 diabetes into remission.
But that’s exactly what a new study (published last month) in the New England journal of Medicine suggests.
The study showed that weight-loss surgery is dramatically more effective in the treatment of type 2 diabetes than a conventional treatment of diet changes and medication. Patients in the study suffered from severe type 2 diabetes and most went into remission after undergoing one of two bariatric surgeries.
The patients were randomly assigned to 3 treatment groups; one group received gastric bypass surgery, a second group had bilopancreatic diversion (BPD) and the third received conventional treatment and medication.
None of the patients in the third group went into remission, but patients who went under the knife saw dramatic improvement. For 95% who had BPD their diabetes went into full remission. They were able to discontinue all diabetes medications and maintain their remission for the 2 year study period. 75% of the group that had a gastric bypass also went into the same remission.
How does it work? Well unfortunately researchers don’t fully understand the process at work, but they do know that the diabetics’ remission is independent of the weight loss from their surgeries.
Dr Rubino said “We found that the change in the anatomy of the stomach and intestines can improve diabetes directly. The stomach and the intestine are not just there for absorption of nutrients. They also serve as an endocrine organ and make dozens of hormones. Those hormones are directly relevant to the regulation of the body’s insulin.”
That doesn’t necessarily mean that WLS will be used for diabetes control in non-obese diabetics, but it does mean that physicians can begin to consider WLS as a treatment for diabetes in obese patients.
Type 2 diabetes is the most common form of diabetes, and it’s rapidly increasing around the world. Dr Rubino went on to say, “This is great news for all diabetics in the world because people think diabetes is a chronic, irreversible disease. There is now evidence that diabetes is not always irreversible. In other words, it is not invincible.”