Jew World Order

MONDAY, March 26 (HealthDay News) — A new international analysis
comparing weight-loss procedures to standard diabetes treatments contends
that surgery is more effective at helping people combat type 2
diabetes.

The finding stems from two years of tracking 60 severely obese patients
with type 2 diabetes who were between the ages of 30 and 60. One-third of
the patients were treated with diabetes drugs and diet/lifestyle
modifications, while the rest underwent one of two surgical procedures:
either Roux-en-Y gastric bypass or biliopancreatic diversion surgery.

The end result: all of the surgical patients were ultimately able to
stop taking their diabetes medications, while the vast majority entered
into full disease remission; neither outcome occurred in the traditional
treatment group.

“We have known for many years that bariatric surgery, and specifically
certain types of operations like gastric bypass, are very effective in
terms of helping to control diabetes,” noted study senior author Dr.
Francesco Rubino, chief of gastrointestinal metabolic surgery and director
of the Metabolic and Diabetes Surgery Center at New
York-Presbyterian/Weill Cornell in New York City.

“But what this new study shows is that even when you compare surgery
against standard treatment, surgery performs far better in terms of the
improvement that you can get in terms of diabetes,” he continued. “Surgery
dramatically reduces blood sugar levels, and very often surgical patients
can stop taking the medications used for diabetes.”

Rubino and his colleagues from Rome’s Catholic University report their
findings in the March 26 online edition of the New England Journal of
Medicine, to coincide with a planned presentation on the findings at
the American College of Cardiology annual meeting in Chicago. Cleveland
Clinic researchers report similar findings in the same journal and plan
to present the results at the same cardiology meeting.

In their study, the Cleveland Clinic doctors followed 150 patients
with type 2 diabetes for a year, and found those who had undergone one of
two types of weight-loss surgeries were much more likely than those on
traditional therapies to get their blood sugar levels lowered to an
optimal point and reduce their use of diabetes medications.

The Italian study authors pointed out that standard medicinal
therapies, while effective, can pose their own set of problems. For one,
insulin therapy can cause patients to gain weight, which itself can have a
negative impact on diabetes.

To explore the comparative benefit of surgical options, the team
focused on 60 diabetic patients who had a body mass index (BMI) of 35 or
more (BMI is a measurement that takes into account height and weight, and
over 30 is considered obese); all had a minimal five-year history of
struggling with diabetes.

Undergoing treatment in Rome, the patients were randomly divided into
three groups. The first was treated with conventional insulin therapy and
a range of other hypoglycemic drugs, alongside what was described as
“rigorous” dietary and exercise counseling. The second and third group had
one of the two types of bariatric surgery, and were placed on a daily
regimen of vitamin and mineral supplementation.

The research team found that all of the surgical patients were able to
stop taking all diabetes medications within just 15 days.

What’s more, at the two-year mark, three-quarters of those who
underwent Roux-en-Y gastric bypass surgery had entered diabetes remission,
meaning that for a minimum of one year they had a fasting glucose level
under 100 milligrams/deciliter and a hemoglobin A1c count of less than 6.5
percent.

The same was true among 95 percent of the biliopancreatic surgery
group. By contrast, none of the patients in the standard treatment group
had entered remission.

The team observed that BMI levels, diabetes history, postsurgical
weight loss, age and gender did not appear to play a role in the
likelihood that patients would enter into diabetes remission.

“Two years is a relatively short outcome,” acknowledged Rubino. “And
this was a small study. But the effect of surgery was almost immediate
among the surgical patients. And I think it’s clear that while patients
getting medicinal therapy did improve somewhat, the chance for patients to
achieve robust improvement in diabetes is much greater for those who have
surgery than those who are treated with standard medications.”

Dr. Loren Wissner Greene, an endocrinologist at NYU Langone Medical
Center in New York City, expressed little surprise at the findings.

“That’s been widely reported,” she noted. “Of course, how one fares
does depend on the individual. One can eat around any procedure, meaning
that if a patient drinks high-caloric liquids following surgery, and
manages not to lose weight, that can affect the result,” Greene
explained.

“At the same time, there is very good evidence for diabetic remission
after surgery, particularly for diverting procedures, where there could be
a beneficial impact on gut hormones like leptin and ghrelin,” Greene
added.

“There are some risks, however,” she cautioned. “And people who have
bad presurgical problems — those with high blood pressure or
obesity-related sleep apnea — might be limited in terms of the type of
obesity surgery they can get. But for those who can do it, it may really
be the better way to go. And in the end, though surgery is extremely
expensive, it might even be cheaper than having to take expensive diabetic
medications for years to come.”

More information

For more on weight-loss surgery, visit the U.S. National Library of Medicine.