Weight Loss Surgery News Blog

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If you have diabetes type 2 and are over weight, "Diabetics Obesity Surgery" might just help.

For years, obesity surgeons have noted that obese people who undergo obesity surgery like gastric bypass (and other type of obesity surgery procedures), almost all experience a reversal of their diabetes. Many achieve normal blood sugar within days after the surgery and are able to end their diabetic medications.

Could those diabetes type 2 sufferers who aren't obese, but just a bit overweight, benefit as well? It's becoming a big issue. According to the American Diabetes Association, 24 million Americans have the disease. The cost of treatment for these is $175 billion.

Current surgical guidlines defines that candidates for obesity surgery must be morbidly obese with a body mass index over 40, or a BMI over 35 plus a weight-related medical problem like diabetes or high blood pressure. Insurance companies use these guidelines in deciding whether to pay for the procedure.

It is reported that Cleveland Clinic is pushing the BMI envelope to see if obesity surgery can make diabetes go away in people who are overweight, but not fat enough (according to the guidelines) to have surgery.

Cleveland Clinic is recruiting 150 overweight and obese Type 2 diabetics with BMIs between 27 and 43 for a study. Some will have surgery and their progress will be compared to those who manage their diabetes with medicine. The goal is to see which group can achieve complete remission.

Link: http://www.robertorizzi.com/diabetic-surgery.htm

With more than 23 million Americans already diagnosed with diabetes, the number of individuals affected by the condition in the U.S. is expected to double over the next 25 years, according to new research.

A study published in the December issue of Diabetes Care claimed that the aging population and the persistence of high obesity rates will produce a populace at a greater risk for type 2 diabetes than in the past, HealthDay News reports.

Researchers expect that the obesity rate will remain stable throughout the study's timeframe, ranging from about 27 percent to 30 percent.

The study predicted the price tag on treating those with diabetes in 2034 will be about $336 billion, about three times the estimated cost for 2009.

According to the Centers for Disease Control and Prevention, about 23 percent of Americans over 60 have diabetes.

Link: http://www.robertorizzi.com/diabetic-surgery.htm

A consensus statement on diabetes surgery is published online today in the Annals of Surgery. This appears the first statement towards a concenus of surgery for diabetes type 2.

At present, bariatric surgery is only available as a treatment for severe obesity, defined as having a body mass index (BMI) of 35 kg/m2 or more, according to National Institutes of Health (NIH) guidelines established in 1991. The DSS consensus statement acknowledges that the cutoff is arbitrary and not supported by scientific evidence, and recognizes the need to use more appropriate criteria for surgery in patients with diabetes.

The report illustrates the findings of the first international consensus conference -- Diabetes Surgery Summit (DSS) -- where an international group of more than 50 scientific and medical experts agreed on a set of evidence-based guidelines and definitions that are meant to guide the use and study of gastrointestinal surgery to treat type 2 diabetes. The document is considered to be the foundation of diabetes surgery as a medical discipline of its own.

In its position statement, the Diabetes Surgery Summit states: "Surgery should be considered for the treatment of type 2 diabetes" in patients with a BMI of 35 or more "who are inadequately controlled by lifestyle and medical therapy." The statement goes on to state that diabetes surgery may also be appropriate for treatment of people with type 2 diabetes and merely mild-to-moderate obesity (BMI 30-35). This goes beyond parameters established by the NIH for bariatric surgery in 1991, which reserved bariatric surgery for people with a BMI of 35 or more with an obesity-related condition, or a BMI of 40 or more with or without any obesity-related condition. These parameters are still adhered to by most insurance companies in determining coverage of the surgery.

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Link: http://www.robertorizzi.com/diabetic-surgery.htm

Obese patients with uncontrolled type 2 diabetes who were treated with an investigational endoscopic duodenal-jejunal bypass liner achieved near normalization of glycemic control in one week, as compared with a sham group. Implantation of the liner was also associated with reductions in fasting blood glucose levels and weight loss.

The EndoBarrier (GI Dynamics) is a non-surgical therapeutic device that is implanted in the gastrointestinal tract through an endoscopic outpatient procedure. It creates a barrier between food and the wall of the small intestine and thereby changes metabolic pathways by controlling how food moves through the digestive system.

In clinical studies conducted to date with the EndoBarrier, patients have experienced immediate resolution of type 2 diabetes while the EndoBarrier is implanted, and continued resolution of their diabetes after the device is removed, as well as the important benefit of weight loss.

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Link: http://www.robertorizzi.com/diabetic-surgery.htm

An ad in the November 15, 2009, edition of Parade magazine may be the opening salvo in a campaign to push adjustable gastric bands as a weight loss aid to help overweight type 2s dramatically improve their symptoms or even go into remission.

The ad for the LAP-BAND AP® System from Allergan, Inc., shows a pretty, overweight, young woman saying, "If I lost the weight, maybe I could improve, or even resolve, my type 2 diabetes." The ad text then discusses the product, which is a device that's placed around the upper part of the stomach and slowly inflated to create a sense of fullness that comes on faster and lasts longer than without the band.

By eating less, a patient fitted with the band can lose a large amount of weight without needing to resort to diets or sheer willpower. The benefit for type 2s is that dramatic weight loss often causes diabetic symptoms to lessen or even disappear

The band, which can be placed in an outpatient procedure, has an advantage over gastric bypass surgery in that it doesn't involve cutting and stapling. This means that the band can be removed relatively easily or adjusted post-procedure without intrusive surgery.

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