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Date: Tuesday Mar. 27, 2012 6:10 AM ET

CHICAGO New research gives clear proof that weight-loss surgery can reverse and possibly cure diabetes, and doctors say the operation should be offered sooner to more people with the disease -- not just as a last resort.

The two studies, released on Monday, are the first to compare stomach-reducing operations to medicines alone for "diabesity" -- Type 2 diabetes brought on by obesity. Millions of Americans have this and can't make enough insulin or use what they do make to process sugar from food.

Both studies found that surgery helped far more patients achieve normal blood-sugar levels than medicines alone did.

The results were dramatic: Some people were able to stop taking insulin as soon as three days after their operations. Cholesterol and other heart risk factors also greatly improved.

Doctors don't like to say "cure" because they can't promise a disease will never come back. But in one study, most surgery patients were able to stop all diabetes drugs and have their disease stay in remission for at least two years. None of those treated with medicines alone could do that.

"It is a major advance," said Dr. John Buse of the University of North Carolina at Chapel Hill, a leading diabetes expert who had no role in the studies. Buse said he often recommends surgery to patients who are obese and can't control their blood-sugar through medications, but many are leery of it. "This evidence will help convince them that this really is an important therapy to at least consider," he said.

There were signs that the surgery itself -- not just weight loss -- helps reverse diabetes. Food makes the gut produce hormones to spur insulin, so trimming away part of it surgically may affect those hormones, doctors believe.

Weight-loss surgery "has proven to be a very appropriate and excellent treatment for diabetes," said one study co-leader, Dr. Francesco Rubino, chief of diabetes surgery at New York-Presbyterian Hospital/Weill Cornell Medical Center. "The most proper name for the surgery would be diabetes surgery."

The studies were published online by the New England Journal of Medicine, and the larger one was presented Monday at an American College of Cardiology conference in Chicago.

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Studies: Weight-loss surgery dramatically improves diabetes

In findings that promise radical changes in the care of the 20 million U.S. patients with Type 2 diabetes, two new clinical trials have shown that weight-loss surgery brings about dramatically greater improvement of blood sugar control in obese diabetics than standard diabetes care.

In both studies, even rigorously supervised regimens of diet, exercise and medications failed to bring blood sugar under good control after a year or more. In contrast, two teams of researchers one in Italy, the other in the United States reported that surgical procedures to reduce the size and sometimes the placement of the stomach often allowed subjects to discontinue diabetes medications within weeks.

Both studies were published online Monday in the New England Journal of Medicine. One of them, by researchers at the Cleveland Clinic and Harvard University, was presented Monday at the American College of Cardiology's annual meeting in Chicago.

In an accompanying editorial in the journal, diabetes specialists Paul Zimmet and K. George M.M. Alberti wrote that although surgical weight-loss procedures were "not yet" a panacea for the worldwide epidemic of Type 2 diabetes, the new research "suggests they should not be seen as a last resort."

"Such procedures might well be considered earlier in the treatment of obese patients with Type 2 diabetes," Zimmet and Alberti wrote. Zimmet is a specialist at the Baker IDI Heart and Diabetes Institute in Melbourne, Australia, and Alberti is at King's College in London.

"Now we know that treating diabetes can and should be a primary reason for doing this surgery," said Dr. Lee M. Kaplan, director of the Massachusetts General Hospital Weight Center. Such surgery should not be the first line of treatment, Kaplan said, but it should become a fallback for patients whose blood sugar control remains poor despite medications and lifestyle changes.

"We ought to be using it more," he said.

Both studies examined patients who had undergone one of three bariatric surgery procedures: biliopancreatic diversion, Roux-en-Y gastric bypass or sleeve gastrectomy. In addition to improved blood sugar control, all experienced significantly greater weight loss than those on standard drug treatment.

Both studies also reported that subjects who had surgery saw more improvement in some, though not all, cholesterol measures than those on standard diabetes therapy.

In general, the studies found that the scale of improvements in patients' metabolic function and weight loss tracked the degree to which the surgical procedures reshaped the gastrointestinal system. Biliopancreatic diversion, the most radical of the operations, appeared to produce the most radical improvements, followed by Roux-en-Y bypass and sleeve gastrectomy.

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Weight-loss surgery effective against diabetes, studies show

CHICAGO -- New research gives clear proof that weight-loss surgery can reverse and possibly cure diabetes, and doctors say the operation should be offered sooner to more people with the disease -- not just as a last resort.

The two studies, released on Monday, are the first to compare stomach-reducing operations to medicines alone for "diabesity" -- Type 2 diabetes brought on by obesity. Millions of Americans have this and can't make enough insulin or use what they do make to process sugar from food.

Both studies found that surgery helped far more patients achieve normal blood-sugar levels than medicines alone did.

The results were dramatic: Some people were able to stop taking insulin as soon as three days after their

In this March 23, 2012 photo, Tamikka McCray, 39, holds photos showing her before a weigh-loss surgery, during an interview at Weill Cornell Medical Center in New York. McCray no longer needed to take diabetes medication and insulin after her weigh-loss surgery. (AP Photo/Bebeto Matthews)

Doctors don't like to say "cure" because they can't promise a disease will never come back. But in one study, most surgery patients were able to stop all diabetes drugs and have their disease stay in remission for at least two years. None of those treated with medicines alone could do that.

"It is a major advance," said Dr. John Buse of the University of North Carolina at Chapel Hill, a leading diabetes expert who had no role in the studies. Buse said he often recommends surgery to patients who are obese and can't control their blood-sugar through medications, but many are leery of it. "This evidence will help convince them that this really is an important therapy to at least consider," he said.

There were signs that the surgery itself -- not just weight loss -- helps reverse diabetes. Food makes the gut produce hormones to spur insulin, so trimming away part of it surgically may affect those hormones, doctors believe.

Weight-loss surgery "has proven to be a very appropriate and excellent treatment for diabetes," said one study co-leader, Dr. Francesco Rubino, chief of diabetes surgery at New York-Presbyterian Hospital/Weill Cornell Medical Center. "The most proper name for the surgery would be diabetes surgery."

The studies were published online by the New England Journal of Medicine, and the larger one was presented Monday at an American College of Cardiology conference in Chicago.

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Weight-loss surgery can reverse diabetes and may cure it, study finds

A new study in the New England Journal of Medicine demonstrates that patients with severe, out-of-control diabetes who received either gastric banding surgery or gastric bypass, had lower blood sugar -- long before they lost weight. NBC's Robert Bazell reports.

By Robert Bazell, Chief Science and Health Correspondent

A "sensational" new finding could be the beginning of a cure for type 2 diabetes, a disease described in an editorial accompanying the research in the New England Journal of Medicine as one of the fastest growing epidemics in human history.

Two studies find that weight loss surgery can eliminate the symptoms of type 2 diabetes in a large proportion of volunteers. That might not seem surprising, since obesity is the major risk factor for the disease. But in these studies, published in the New England Journal of Medicine and presented Monday at the annual meeting of the American College of Cardiology, many of the patients got better within weeks, days, sometimes even hours after the surgery -- long before they lost any weight.

Its pretty amazing, said Dr. Phil Schauer of the Cleveland Clinic, the lead author on one of the studies. Schauaers study divided 150 patients with out-of-control diabetes into three groups. One-third got the best drug therapy, the next gastric-banding surgery, and last gastric bypass. The goal was to get the patients blood sugar (measured by the A1C test familiar to diabetics) below the normal level of 6 percent. Forty-two percent of the bypass patients reached the goal after one year compared to 37 percent of the banding patients and only 12 percent on medical therapy.

But those numbers dont even begin to show how successful this was," according to Dr. Steve Nissen, another author of the paper from the Cleveland Clinic. He points out that at the beginning of the study most of the patients were taking three or more medications to control their diabetes. But after a year almost none of the gastric-bypass patients needed medication. Forty-four percent required daily insulin injections before surgery and none did after. Diabetes is a major risk factor for heart disease. Most of the surgery patients saw their HDL, the good cholesterol, shoot way up and their artery clogging triglycerides drop sharply.

This is sensational, Nissen told me.

The second study from the Catholic University of Rome and Weill Cornell Medical College followed sixty patients for two years and produced even stronger results. In that experiment one third of the volunteers got drug therapy, one third bypass surgery, and the last group underwent bilopancreatic diversion, an even more severe weight-loss operation where surgeons block part of the small intestine.

After two years none of the patients on drug therapy reached the goal of normal blood sugar levels while 75 percent of those who underwent bypass did and as did fully 95 percent of those undergoing the bilopancreatic diversion. The authors of the study say these patients have achieved complete diabetes remission. Though the doctors have followed them for only two years, there is no indication that the diabetes is returning in any of them.

Why, in some patients, do the positive effects take place long before they lose weight? Marla Evans, 56, one of the volunteers who got gastric banding in the Cleveland study put it this way, I was a diabetic, and then after the surgery, within a few days, the diabetes was much better, and within a month or two therewas no diabetes in my blood at all.

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Weight loss surgery eliminates diabetes symptoms

Posted: 4:57 PM Updated: 5:07 PM

CHICAGO New research gives clear proof that weight-loss surgery can reverse and possibly cure diabetes, and doctors say the operation should be offered sooner to more people with the disease not just as a last resort.

click image to enlarge

ITamikka McCray, 39, holds photos showing her before weigh-loss surgery, during an interview at Weill Cornell Medical Center in New York recently.

AP

The two studies, released on Monday, are the first to compare stomach-reducing operations to medicines alone for "diabesity" Type 2 diabetes brought on by obesity. Millions of Americans have this and can't make enough insulin or use what they do make to process sugar from food.

Both studies found that surgery helped far more patients achieve normal blood-sugar levels than medicines alone did.

The results were dramatic: Some people were able to stop taking insulin as soon as three days after their operations. Cholesterol and other heart risk factors also greatly improved.

Doctors don't like to say "cure" because they can't promise a disease will never come back. But in one study, most surgery patients were able to stop all diabetes drugs and have their disease stay in remission for at least two years. None of those treated with medicines alone could do that.

"It is a major advance," said Dr. John Buse of the University of North Carolina at Chapel Hill, a leading diabetes expert who had no role in the studies. Buse said he often recommends surgery to patients who are obese and can't control their blood-sugar through medications, but many are leery of it. "This evidence will help convince them that this really is an important therapy to at least consider," he said.

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Studies: Weight-loss surgery can reverse diabetes

COLUMBUS, Ohio --

Women aren't alone in the battle of the bulge.

"I've always fought my weight. Portion size is a battle; food is plentiful," said Myles Noel who is training for his next marathon at age 61.

The numbers are staggering. According to the Centers for Disease Control and Prevention, more than one-third of American adults (35.7 percent) are obese.

The gender that seemed to be immune to the pressures of staying thin is now facing a reality check as they step on the scale. More men are taking their weight loss, health and fitness seriously. And the weight loss companies know it, launching campaigns that revolve around men.

Charles Barkley, former NBA basketball player and current analyst, is the pitchman for Weight Watchers for Men, making claims on the Weight Watchers website that he has lost 40 pounds.

It makes sense that WW would seek a famous athlete to represent their health and wellness program, and many men have joined the WW ranks.

Nutritsystem launched a men's program with Terry Bradshaw's face as the inspiration for weight loss. And Jenny Craig added a men's weight-loss program, calling it "Jenny for Men."

While there is weight to be lost, there is also money to be made, and these companies understand individual programs targeted specifically to men open up their audience and clients.

"I think it's genius gearing it towards men," said Jennifer Burton, a registered dietitian at McConnell Heart Health Center in Columbus. She says men and women often lose weight differently.

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Weight Loss Companies Battle For Men

In the first head-to-head studies comparing weight-loss surgery to medication for diabetes, surgery proved more effective in putting the disease in remission.

Two new studies find that weight-loss surgery is significantly more effective than standard treatments for controlling blood sugar in overweight and obese people with Type 2 diabetes.

Although research has previously hinted that bariatric surgery, which shrinks the stomach and reroutes food to the intestines, can reverse diabetes sometimes even before patients leave the hospital the two new studies published Monday in the New England Journal of Medicine are the first randomized trials to pit surgery against standard treatments head-to-head.

Compared with patients getting blood-sugar-controlling medication and counseling in diet and exercise, those who received bariatric surgery were far more likely to be free of diabetes or to have reduced their dependence on diabetes medications for at least two years, compared with those not getting the surgery.

MORE: Bypassing Obesity for Alcoholism: Why Some Weight-Loss Surgeries Increase Alcohol Risk

By closing off most of the stomach to food, people who receive bariatric surgery eat less and, therefore, lose weight. Patients in the studies lost about five times as much weight on average as those only taking blood-sugar-lowering medications. Weight gain is key a risk factor for Type 2 diabetes, and losing excess weight can help many patients control their disease. But doctors also believe that weight-loss surgery itself, independent of weight loss, can help manage diabetes. Eating too many calories can overwhelm the bodys insulin-producing abilities and lead to higher levels of unprocessed sugar in the blood, so stomach-shrinking surgery may benefit patients by helping them consume less.

Bariatric surgery should not be considered just weight-loss surgery, Dr. Francesco Rubino of Weill Medical College of Cornell University and author of one of the studies, told ABC News, but a means to treat diabetes and metabolic disease.

In one study, led by Rubino and his colleagues at the Catholic University in Rome, 75% of the patients who had bariatric surgery no longer had diabetes after two years, compared with zero patients who relied on drug treatments alone.

In the second trial, led by researchers at the Cleveland Clinic, 37% to 42% of patients having the surgery and using diabetes medications were able to keep their blood glucose levels below the threshold doctors use to diagnose diabetes, compared with 12% of those who depended only on the medications, after a year.

The result is simply stunning, Dr. Steven Nissen, chairman of cardiovascular medicine at the Cleveland Clinic and an author of the paper, told USA Today.

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Weight-Loss Surgery Works Better than Drugs to Control Diabetes

DENVER, March 26, 2012 /PRNewswire/ --The American Society of Bariatric Physicians (ASBP) today released a set of weight-loss tips that are effective for improving and reversing type 2 diabetes.

Tips for Sustainable Weight Loss When Suffering from Type 2 Diabetes

"The key in sustaining weight loss is to identify the right solution for each patient," said Ed J. Hendricks, M.D., of The Center for Weight Management in Roseville, Calif., an obesity medicine specialist with a large obesity treatment practice that includes many overweight diabetics. "There is a large spectrum of choices, from self-help programs to medical therapy to surgery. However, the obesity medicine physician is a patient's best resource in mapping out an effective, comprehensive plan for the individual."

The preceding tips were taken from the ASBP Overweight and Obesity Evaluation Management Guidelines. Obesity is a lifelong problem, and there are several tools for weight loss. Patients are encouraged to partner with physicians who have the expertise to guide them through what treatment plans will be most effective given their individual medical histories and conditions.

Founded in 1950, ASBP (www.asbp.org) is the oldest medical association dedicated to the non-surgical treatment of obesity and associated diseases. ASBP is a collaborative organization that provides its members practical information and business tools to implement a successful medical bariatric practice.

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Obesity Medicine Physicians Offer Sustainable Weight Loss Tips to Type 2 Diabetic Patients

(CBS/AP) Nearly 26 million Americans have type 2 diabetes, and now researchers say they may have a way to reverse the disease for many of them. Their studies give clear proof that weight-loss surgery can reverse and possibly cure diabetes and doctors are saying more people should be offered the surgery, and not just as last resort..

New study: Weight-loss surgery may cure diabetes Diabetes: 5 dumb ways to boost your risk

The two studies, released on Monday in the New England Journal of Medicine, are the first to compare stomach-reducing operations to medicines alone for "diabesity" - Type 2 diabetes caused by obesity. Millions of Americans have it, and can't make enough insulin to process sugar from what they eat.

Both studies found that surgery helped far more patients achieve normal blood-sugar levels than medicines alone did. Some were able to stop taking insulin as soon as three days after their surgeries. Cholesterol and other heart risk factors also improved dramatically.

Doctors don't like to say "cure" because they can't promise a disease will never come back. But in one study, most surgery patients were able to stop all diabetes drugs and have their disease stay in remission for at least two years. None of those treated with medicines alone could do that.

"It is a major advance," said Dr. John Buse, a diabetes researcher at the University of North Carolina at Chapel Hill, who was no involved in the studies. Buse said he often recommends surgery to patients who are obese and can't control their blood-sugar through medications, but many are leery of it. "This evidence will help convince them that this really is an important therapy to at least consider," he said.

There were signs that the surgery itself - not just weight loss - reverses diabetes. Food makes the gut produce hormones to spur insulin, so doctors think trimming away part of it surgically may affect those hormones.

Weight-loss surgery "has proven to be a very appropriate and excellent treatment for diabetes," said one study co-leader, Dr. Francesco Rubino, chief of diabetes surgery at New York-Presbyterian Hospital/Weill Cornell Medical Center. "The most proper name for the surgery would be diabetes surgery."

More than a third of American adults are obese, and more than 8 percent have diabetes, a major cause of heart disease, strokes and kidney failure. Between 5 million and 10 million are like the people in these studies, with both problems.

For a century, doctors have been treating diabetes with pills and insulin, and encouraging weight loss and exercise with limited success. Surgery offers hope for a long-term fix. It costs $15,000 to $25,000, and Medicare covers it for very obese people with diabetes. Gastric bypass is the most common type: Through "keyhole" surgery, doctors reduce the stomach to a small pouch and reconnect it to the small intestine.

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Weight-loss surgery can "reverse" diabetes, studies confirm

Weight-loss surgery did a better job of controlling type 2 diabetes in overweight and moderately obese patients than the most advanced medical treatment for the disease, researchers said on Monday.

The study, conducted at the Cleveland Clinic and presented at the annual scientific sessions of the American College of Cardiology in Chicago, showed that patients who underwent surgery were more than three times more likely to gain control over their diabetes after one year than the group that was treated with drugs.

Uncontrolled diabetes is a major risk factor for heart problems, including heart attack.

"Within days and hours of surgery -- before there's any measurable weight loss -- we saw dramatic changes. A majority of(surgery) patients left the hospital with normal blood sugars. However, this was not as effective for people who had diabetes for many years," said Dr. Philip Schauer, director of Bariatric and Metabolic Institute at the Cleveland Clinic, who led the clinical trial.

Shauer called the findings, which were published in the New England Journal of Medicine, "a potential paradigm change" for how some patients should be treated for diabetes.

In the study, dubbed STAMPEDE, researchers randomly assigned 150 patients -- three-quarters of them female -- with a body mass index between 27 and 43 into one of three groups.

There were two surgery groups -- laparoscopic gastric bypass, a surgery that reroutes the digestive system and allows food to bypass part of the small intestine, and sleeve gastrectomy, a procedure that reduces the stomach to about one- quarter of its original size.

The two surgery groups were compared with a third group that got the most advanced non-insulin treatment for diabetes, such as liraglutide, marketed by Novo Nordisk under the brand name Victoza.

The research was primarily funded by Johnson & Johnson's Ethicon Endo-Surgery Inc, a maker of surgical instruments used for bariatric surgery.

Reaching the goal

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Weight-loss surgery better for controlling diabetes than drugs