Gastric bypass shows signs of curing diabetes

Gastric bypass surgery has helped thousands lose weight, but many obese patients also diagnosed with diabetes are getting some unexpected good news.

With the worldwide number of diabetes cases expected to exceed 380,000,000 by 2025 a cure for the disease has never been needed more.

Chef and teacher at the Institute of Culinary Education Tom Haynes was set to become one of the millions living with diabetes, until gastric bypass surgery changed things for him.

Haynes used to weigh in at 285 and had been diabetic for 10 years.

"I had to stab myself 13 times a day with insulin," said Haynes.

Now, after undergoing gastric bypass surgery, Haynes is insulin-injection and medication-free.

Doctor Francesco Rubino at New York-Presbyterian/Weill Cornell is now spearheading studies into gastric bypass surgery and its effects on type-two diabetes. The surgery, widely used since 1999, has shown signs of an unexpected side effect when performed on morbidly obese patients.

"Some patients who take insulin for type-two, they have an operation, and very often, we don't put them back on insulin," said Rubino. "I noticed some patients had diabetes remission as early as days or weeks after the operation."

The surgery, once only available for people with body mass indexes (BMI) over 35, is now part of a new clinical trial at New York-Presbyterian to observe if it can be used for people suffering from diabetes with BMI as low as 26.

"I thought changing the gut anatomy, you change the way the way the gut speaks to the body," said Rubino.

Meaning that the way the pancreas creates insulin does not work properly for people with type-two diabetes. Why the surgery sends diabetes into remission remains a mystery.

The surgery, which changed Haynes life, could save millions. Rubino also believes the surgery would be cost-effective as studies show the costs of a one-time bariatric surgery are offset by the reduced diabetes-related medical costs.

Research Summary:
Weight loss procedure curing diabetes?

Background: According to the Mayo Clinic, gastric bypass is the most frequently performed bariatric surgery in the United States. Many surgeons prefer gastric bypass surgery because it generally has fewer complications than other weight loss surgeries. Gastric bypass surgery can provide long-term, consistent weight loss if the patient exercises and eats a healthy diet. The surgery combines the creation of a small stomach pouch to restrict food intake and construction of bypasses of the duodenum and other segments of the small intestine to cause malabsorption, which decreases the ability to absorb calories and nutrients from food.

Benefits: Extreme obesity affects nearly 24 million adults, which is nearly 6 percent of Americans. It is associated with more than 30 medical conditions, including type 2 diabetes, coronary heart disease, stroke, hypertension, sleep apnea, joint disease, and cancer. According to WebMD Health News, 89 percent of people with type 2 diabetes who underwent gastric bypass surgery went into remission, and 57 percent were still in remission after five years. The cost of treating diabetes is enormous. A person diagnosed at age 50 can expect to spend $172,000, which is the equivalent of seven gastric bypass procedures. Diabetes has disappeared in some patients almost immediately or within days of gastric bypass surgery. Blood sugar levels begin to fall soon after surgery, becoming completely normal within a year.

Surgery As Diabetes Treatment: The International Diabetes Federation, which represents more than 200 diabetes groups across the globe, called for weight loss surgery to be considered a treatment for type 2 diabetes in certain patients with body mass indexes (BMIs) as low as 30. Improvements in general health are also common after this surgery. Obesity-related medical conditions usually improve or even go away after gastric bypass surgery; including arthritis, obstructive sleep apnea, and high blood pressure. About 95 percent of people report improved quality of life after weight loss surgery. Some studies also suggest people live longer after weight loss surgery compared to equally obese people who do not have surgery. (SOURCE: http://www.idf.org/)

For more information, contact:
*Andrew Klein, Public Relations
New York-Presbyterian/Weill Cornell
Ank2017@med.cornell.edu


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