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.

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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

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

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

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

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

(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

Public release date: 26-Mar-2012 [ | E-mail | Share ]

Contact: Ellen Acconcia eacconcia@sirweb.org 703-460-5582 Society of Interventional Radiology

A minimally invasive treatment may target hunger at its source, another uses X-ray visible embolic beads to block arteries to the stomach and suppress hunger and a third explores the use of stem cells to repair vertebral disc degeneration. Initial results from all these studies were reported at the Society of Interventional Radiology's 37th Annual Scientific Meeting in San Francisco, Calif.

Approximately 127 million Americans (or 65 percent) are overweight, obese or morbidly obese, according to the Centers for Disease Control and Prevention. The rate of morbid obesity is also rising rapidly. Two new studies that explored the use of proven interventional radiology treatments in new ways may have the potential to help individuals with morbid obesity.

"Currently, there are three clinically viable surgical alternatives for obesity: gastric bypass surgery, gastric pacing and endoscopic gastric banding. These procedures have varying success rates; they are invasive, require extensive gastric/bowel reconstruction or external devices and can have significant surgical complications," explained Charles Y. Kim, M.D., assistant professor of radiology at Duke University Medical Center in Durham, N.C., and lead investigator on one of the studies.

"Our promising results led us to believe that a minimally invasive interventional radiology treatmentcalled bariatric arterial embolizationwould allow for precise targeting of a specific portion of a person's stomach in order to decrease production of ghrelin, a hormone that causes hunger. This treatment could one day be the answer for those who have not been successful with weight loss through diet and exercise," said Kim.

Embolization is a minimally invasive technique where an interventional radiologist uses a thin catheter to inject tiny particles into an artery supplying the area being treated with the goal of blocking tiny vessels to starve it of its blood supply.

"Interventional radiologists have safely and effectively used embolization in many other disease states for decades," stated Kim. "For this study, we selectively blocked and decreased the blood flow to a very specific part of the stomach using specialized radiologic equipment, which led to significantly decreased levels of ghrelin in the animals that we treated. We found that when ghrelin levels decrease, appetite and hunger also decrease, causing weight loss in the treated animals relative to non-treated animals," Kim continued. "Bariatric arterial embolization may have a future use in treating obesity in humans by significantly suppressing appetite to achieve weight loss," he said.

The researchers will continue studies aimed at the reduction and elimination of complications, such as stomach ulcers, and expressed confidence that bariatric arterial embolization is very close to moving toward the clinical trial phase in the United States.

A second study tested a new type of X-ray-visible embolic bead in bariatric arterial embolization.

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No pain, no gain: Weight loss, disc disease interventional radiology treatments coming

By Liz Szabo, USA TODAY

CHICAGO - Obesity surgery can reverse the signs of diabetes, according to small new study, allowing many patients to quickly reach normal blood-sugar levels while reducing or eliminating their need for insulin or other medications.

In the study of 150 patients with Type 2 diabetes, 42% of those randomly assigned to the stomach-reducing surgery saw their blood sugar drop to normal levels, according to research presented in Chicago at the annual meeting of ithe American College of Cardiology. Some patients who had the operations, called bariatric surgery, improved so rapidly that they went off their diabetes medications before leaving the hospital, says lead investigator Philip Schauer, a professor of surgery and director of the Bariatric and Metabolic Institute at the Cleveland Clinic.

Improving blood sugar is vital, because patients in the study had suffered from "uncontrolled" diabetes for eight years or more, in spite of seeing their doctors regularly, says co-author Steven Nissen, chairman of cardiovascular medicine at the Cleveland Clinic. High blood sugar increases the risk of diabetic complications, such as heart attacks, kidney failure, amputations and blindness. Patients began the study with very high blood sugar, as measured by a test called hemoglobin A1c, or HA1c. Patients' average baseline HA1c levels were 9.2%; a level of 6% or lower is considered healthy. After surgery, nearly half reached about that level.

"The result is simply stunning," Nissen says. Nissen says he's reluctant to say that the operation, known as bariatric surgery, actually cured diabetes, because patients have been followed only for one year. "But from a biochemical point of view, they were no longer diabetic."

Patients agreed to let researchers randomly assign them to one of three treatments, according to the study, published in the New England Journal of Medicine. One-third received intensive therapy with multiple drugs, plus counseling and lifestyle changes; one-third received medications plus underwent "sleeve gastrectomy" surgery to remove up to 80% of the stomach; one-third got medications and had a more extensive surgery called gastric bypass, which reduces the stomach to 2% to 3% of its former size, then reconnects it to the small intestine.

Patients treated with intensive medications, who saw their doctors every three months, also improved, but not as much. About 12% achieved a normal blood sugar, the study says. Heather Britton, 53, says she's 73 pounds lighter today than when she had a gastric bypass during the study, three years ago. She describes her diabetes as "in remission." She was able to go off all of her medications - for diabetes, high blood pressure and high cholesterol - within three months of surgery, and no longer suffers from asthma or food allergies. Britton is no longer able to eat fatty foods, such as ice cream or peanut butter, which make her feel sick. But she's exercising regularly and feels better than ever. "It's been wonderful," says Britton, of Bay Village, Ohio, who has lost several family members to diabetes. "It's changed my destiny."

Yet surgery poses risks, Schauer says. The most common complications in the study were dehydration and bleeding. One patient developed a gastrointestinal leak from the surgical site. That's a serious issue, because it can lead to a dangerous infection. Four of 100 surgical patients needed additional surgeries to fix these complications within a year of their operation. No one died or suffered a life-threatening or debilitating complication.

Patients treated at community hospitals may not achieve the same results as those treated at the Cleveland Clinic, a top-tier center, says Brian Sabowitz, a bariatric medicine specialist in San Antonio. He advises patients to look for a surgeon who performs at least 150 bariatric surgeries a year. In general, about 15% to 20% of patients undergoing these procedures suffer a complication, such as nausea or needing intravenous fluids, although only 1% suffer a serious complication. The death rate from the surgery is 1 in 2,000.

Researchers plan to follow patients for three to four years to see how long such "remissions" last. They will also compare the long-term costs of the three approaches. Surgery can cost $25,000 and may not be covered by insurance, Schauer says. Years of treatment with drugs can be expensive, as well. Patients whose diabetes isn't controlled may need surgery or other expensive, invasive procedures, such as kidney dialysis, Nissen says.

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Studies: Weight-loss Surgery can put Diabetes into Remission

Weight-loss surgery may be best cure for diabetes March 26th, 2012, 12:13 pm posted by Courtney Perkes

Two studies published Monday in the New England Journal of Medicine have found that bariatric weight-loss surgery can reverse diabetes in obese patients far more effectively than medication and lifestyle coaching alone.

In summary, the studies showed some dramatic results, including patients who could stop taking insulin only days after surgery, even before losing large amounts of weight.

Dr. Peter LePort, bariatric surgeon at Orange Coast Memorial Medical Center in Fountain Valley, estimated that 25 to 35 percent of his patients have type 2 diabetes.

A significant portion of my patients come in not only because theyre heavy but they say, I have to get rid of my hypertension, my diabetes, my back pain and thats motivating them more than the weight loss, LePort said. The significant thing here is gastric bypass seems to get rid of diabetes very quickly even before they lose all the weight.

LePort said he would like to see research on if gastric surgery can cure diabetes in patients who are not morbidly obese.

In one study, patients at the Cleveland Clinic who underwent stomach-shrinking surgeries were compared with those who took medication and received intensive lifestyle and weight loss coaching. After a year, the surgery patients had lost more weight and many were able to control their blood sugar without medication.

The authors wrote, We conclude that bariatric surgery represents a potentially useful strategy for management of uncontrolled diabetes, since it has been shown to eliminate the need for diabetes medications in some patients and to markedly reduce the need for drug treatment in others.

In the other study at Catholic University in Rome, patients who underwent surgery were also compared to those who didnt. For those who had surgery, the remission rate from diabetes was up to 95 percent. As in the other study, the surgery patients also lost more weight.

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Weight-loss surgery may be best cure for diabetes