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

Posted: March 27, 2012 at 12:20 am

(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..

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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


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