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diabetes and weight loss surgery

**** - Reversal of Type 2 diabetes - "Because obesity is the primary risk factor for Type 2 diabetes, weight-loss surgery can have a profound impact on the condition," says Dr. Nicholson. Published in the March 2009 issue of The American Journal of Medicine, a study revealed that 82 percent of patients who had weight-loss surgery reversed their diabetes in less than two years, and 62 percent remained diabetes free two years following surgery.****

This study actually came out with a lower rate of "reversal" than the Monash or SOS which found 72 percent of diabetics with a normal A1C in 2 years after surgery. Many things should be remembered. 1. NO researcher in studies *I*'ve read has used the word "reversal" or "cure". They say REMISSION. Diabetes is not curable. 2. The Swedish Obesity Study (SOS afore mentioned) found 72 percent with a normal A1C 2 years after surgery but 10 years after surgery, the picture was opposite... almost 70 free WERE NOT in remission. (36 percent of patients were still "diabetes free") (chart showing these results)

SOURCE: New England Journal of Medicine: Volume 351:2683-2693 December 23, 2004 Number 26 Lifestyle, Diabetes, and Cardiovascular Risk Factors 10 Years after Bariatric Surgery Lars Sjostrom, M.D., Ph.D et al

The Monash study selected ONLY patients who had been diagnosed for less than 2 years and only followed for 2 years. It's well known that most dietary modifications and a moderate exercise program will keep the BSL's of most diabetics at normal level for many years after diagnosis. As far as "obesity being the main factor in diabetes" how does the author explain the admitted 33 percent of type II adult diabetics who were never obese?

The authors of one study which noted an instant drop in blood sugar levels right after surgery, admitted in an "honest moment" that it was impossible to tell whether the drop in blood sugar levels were due to the after surgery fasting or the surgery itself.

Finally the RNY or gastric bypass can cause other problems with the pancreas which are much harder to treat than diabetes:

A clinical study of 63 gastric bypass patients by Mitchell Roslin and associates, has disproven this theory when it found that not only did 80 percent of the gastric bypass patients in their study suffer a RAVENOUS appetite soon after meals, but also experienced the almost uncontrollable urge to eat which did for many result in weight regain after the first year (the study went for 4 years).

The researchers also found that 80 percent of the patients also had undiagnosed "glucose abnormalities" including "high blood sugar" or "low blood sugar" or both. Dr. Roslin reported on this study at the 2009 ASMBS convention, suggesting that the gastric bypass may cause a heightened insulin response due to the rapid emptying of the pouch into the small bowel.

Roslin M, et al "Abnormal glucose tolerance testing following gastric bypass" Surg Obesity Related Dis 2009; 5(3 Suppl): Abstract PL-205.

Reported at the ASBMS convention by Roslin

Created on ... June 03, 2010