surgery

Is Gastric Bypass Surgery a Cure?

David Mendosa Health Guide April 23, 2010
  • Gastric bypass surgery is getting more and more attention as a potential cure for type 2 diabetes. For example, Dan Hurley's outstanding recent book Diabetes Rising, which I reviewed here, included it in the author's section on cures for diabetes.Usually people define a cure based on fastin...

29 Comments
  • Gretchen Becker
    Health Guide
    Apr. 24, 2010

    Did anyone at the conference have any theories about why the BGs go up again after some months?

    • David Mendosa
      Health Guide
      Apr. 24, 2010

      Dear Gretchen,

       

      None that I heard. And I reported everything relevant that I heard.

       

      David

  • My Bariatric Life
    Health Guide
    Apr. 16, 2012

    My diabetes has been in remission ever since I had gastric bypass surgery in 2003. After losing only 50 lbs (I lost 100 lbs in total) I was able to get off insulin, two oral diabetic medications, as well as two oral medications for hypertension.

     

    You may find this of interest: One study investigated the rate of type 2 diabetes remission after...

    RHMLucky777

    Read More

    My diabetes has been in remission ever since I had gastric bypass surgery in 2003. After losing only 50 lbs (I lost 100 lbs in total) I was able to get off insulin, two oral diabetic medications, as well as two oral medications for hypertension.

     

    You may find this of interest: One study investigated the rate of type 2 diabetes remission after gastric bypass and banding and the reasons leading to remission of type 2 diabetes after bariatric surgery. It showed gastric bypass being significantly more successful than gastric banding.

     

    http://www.medscape.com/viewarticle/733691

     

    Despite similar weight loss, 72% of bypass versus 17% of banding patients sustained remission of their diabetes three-years following the surgeries.

     

    -MBL

  • Anonymous
    Anonymous
    May. 31, 2010

    <!--[if gte mso 9]<xml Normal 0 false false false MicrosoftInternetExplorer4 </xml<![endif]--<!--[if gte mso 9]<xml </xml<![endif]--<!-- --<!--[if gte mso 10] <mce:style<! /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes;...

    RHMLucky777

    Read More

    <!--[if gte mso 9]><xml> Normal 0 false false false MicrosoftInternetExplorer4 </xml><![endif]--><!--[if gte mso 9]><xml> </xml><![endif]--><!-- --><!--[if gte mso 10]> <mce:style><! /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} --> <!--[endif]-->

    There is a surgical procedure - duodenal exclusion (duodenal exclusion with a loop duodenojejunostomy) - for non-obese (overweight, slightly overweight or in the normal category) people with a BMI of under 30 suffering from Type 2 diabetes which is being done in Costa Rica which has eliminated Type 2 diabetes with an 80-90% success rate. It involves removing or bypassing part of the upper small intestine or duodenum, so that food from the stomach goes directly into the lower small intestine - most importantly, removing the duodenum from the nutrient flow.

    This surgery is done laparascopically. But unlike the gastric sleeve, the stomach is not touched. Stomach volume is kept intact, maintaining the caloric ingestion so that in many instances, the patient undergoing duodenal exclusion will lose less than 5% of her/his pre-op weight, eliminating potential nutritional zig-zags and drastic dietary changes that may follow other types of bariatric surgery.

    The impact of this procedure on overweight, slightly overweight or normal-weight diabetes patients can be dramatic. Some patients find that within a few days of duodenal exclusion, they no longer need diabetes medication; others take just over a month to end dependence. In addition, this health-bringing change usually occurs with no weight loss.

    One preliminary study of just under 100 overweight (but non-obese) or slightly overweight patients who had undergone duodenal exclusion showed that over a 9-12 month period, almost 80% had a complete remission or great improvement of their Type 2 diabetes, independent of their weight loss or gain over the period examined. Some actually gained weight, but still remained diabetes free.

    Two large-scale trials published in the summer of 2009 in the New England Journal of Medicine have shown that patients who underwent a duodenal exclusion had a 92% reduction in diabetes-associated death.

    The duodenal procedure does not require much active follow-up participation on the part of patients. Patients can get back to normal life very quickly, and maintain a virtually normal diet with almost no restrictions on the types of food that they can eat.

    Not everyone with a BMI under 30 is eligible for this surgery. If you think you are in this category and are considering bariatric surgery to cure Type 2 diabetes, contact me at msydney@gmail.com or call me toll-free from the U.S. and Canada at 1-800-407-9438 for more info and the chance to talk to Dr. Jacobo Zafrani, who performs this operation - as well as gastric sleeves, etc. - in San José, Costa Rica.

     

  • pttugas
    May. 07, 2010

    Quick Weight Loss

    If you are seeking out a motivating diet, then the cabbage soup diet is definitely the way to go. You can eat as much cabbage soup as you like. There are also a selection of other foods that you can eat while on this diet. Then again, the diet does decrease the number and varieties of foods other than cabbage soup that you can have. It is a...

    RHMLucky777

    Read More

    Quick Weight Loss

    If you are seeking out a motivating diet, then the cabbage soup diet is definitely the way to go. You can eat as much cabbage soup as you like. There are also a selection of other foods that you can eat while on this diet. Then again, the diet does decrease the number and varieties of foods other than cabbage soup that you can have. It is a good idea before you commence the cabbage soup diet that you determine whether or not you are fond of cabbage soup! There is also another diet known as the three day diet. This diet has a large amount of variety of foods in contrast to the cabbage soup diet, but most of the drinks in this three day diet are restricted to coffee and tea. Lots of people look for the diet that can promise them a very large amount of weight loss in a pretty brief period of time. This makes the grapefruit diet quite attractive to a lot of people. With the grapefruit diet, you are fundamentally given the list of the minimum amounts of food that you can eat, rather than the most! While there are something about the diet that you are not supposed to change, such as making sure that you always eat the bacon at breakfast, this diet is extremely incredible.Bear that you know yourself better than anyone else, so when you are coming to a decision on which dietsfor quick weight loss are right for you, you might want to try a diet that meets with what you want and need. If you won’t to get on with the diet, simply because you cannot enjoy the food, then you will not achieve anything.
    http://pttugas.co.cc

  • Anonymous
    tmana
    Apr. 24, 2010

    Based on information published in American Association of Clinical Endrocrinologists' Medical Guidelines for Clinical Practice for the Management of Diabetes Mellitus (2007), at the point of diagnosis of Type 2 Diabetes Mellitus, a person has already lost 50% of his beta cell function. (Some folk will use the figure 80%.)

     

    Unless the one-time treatment...

    RHMLucky777

    Read More

    Based on information published in American Association of Clinical Endrocrinologists' Medical Guidelines for Clinical Practice for the Management of Diabetes Mellitus (2007), at the point of diagnosis of Type 2 Diabetes Mellitus, a person has already lost 50% of his beta cell function. (Some folk will use the figure 80%.)

     

    Unless the one-time treatment restores, revives, or regrows beta cells, with full beta cell function, diabetes has not been cured. It may have been arrested or mitigated -- even to the point of no longer requiring medication -- but it is not cured.

    • David Mendosa
      Health Guide
      Apr. 25, 2010

      That's just what I have been thinking. Well said!

       

      David

  • nonegiven
    Apr. 24, 2010

    Amputating part of your digestive system is NOT going to auto-magically regenerate your ß-cells.  Anyone who says it will is lying.  The gastric bypass is lowering blood sugars because the post surgery diet is LOW CARB!

     

     

     

     

  • Gretchen Becker
    Health Guide
    Apr. 24, 2010

    What was this guy's fasting and A1c when his postprandial BGs were going over 200?

     

    What were his postprandial numbers when his A1c was 6.1?

     

    It's difficult to compare the early and late results without all the data. An A1c of 6.1 with insulin doesn't mean that one is cured. People with type 1 diabetes can have A1cs of 6 or even lower.

     

    The...

    RHMLucky777

    Read More

    What was this guy's fasting and A1c when his postprandial BGs were going over 200?

     

    What were his postprandial numbers when his A1c was 6.1?

     

    It's difficult to compare the early and late results without all the data. An A1c of 6.1 with insulin doesn't mean that one is cured. People with type 1 diabetes can have A1cs of 6 or even lower.

     

    The "after 7 months" makes one think his control gradually deteriorated, but perhaps it deteriorated a few days after he stopped using insulin. Maybe they didn't test that. So perhaps the problem was taking him off insulin and following him carefully shortly after that.

    • Aggie
      Apr. 24, 2010

      Here is another source on this story:

       

      http://www.medpagetoday.com/MeetingCoverage/AACE/19727

       

      Notice what it says at the end...

       

      Arthur Chernoff, MD, chair of endocrinology at Albert Einstein Medical Center in Philadelphia, said the results are feasible, as it's challenging to decide at which point the patient indeed has diabetes.

      "It doesn't...

      RHMLucky777

      Read More

      Here is another source on this story:

       

      http://www.medpagetoday.com/MeetingCoverage/AACE/19727

       

      Notice what it says at the end...

       

      Arthur Chernoff, MD, chair of endocrinology at Albert Einstein Medical Center in Philadelphia, said the results are feasible, as it's challenging to decide at which point the patient indeed has diabetes.

      "It doesn't surprise me that some patients [who've had bariatric surgery] will have high blood sugar because I don't think that the procedure cures whatever it is that's causing diabetes in the first place," said Chernoff, who wasn't involved in the study.

      The numbers are just a symptom. They are not the disease.

    • Gretchen Becker
      Health Guide
      Apr. 24, 2010

      Thanks Aggie.

       

      From that story:

       

      "At four months, he'd lost more than 100 pounds, and his HbA1c and fasting plasma glucose were markedly improved -- falling from 9 to 6.1%, and into the normal 90 to 150 mg/dL range, respectively."

       

      I wouldn't call a fasting of 150 normal range. Maybe they meant "from 150 to 90 mg/dl."

       

      "At that point,...

      RHMLucky777

      Read More

      Thanks Aggie.

       

      From that story:

       

      "At four months, he'd lost more than 100 pounds, and his HbA1c and fasting plasma glucose were markedly improved -- falling from 9 to 6.1%, and into the normal 90 to 150 mg/dL range, respectively."

       

      I wouldn't call a fasting of 150 normal range. Maybe they meant "from 150 to 90 mg/dl."

       

      "At that point, he no longer needed insulin."

       

      More accurately, at this point his doctor didn't think he needed insulin, as David wrote.

       

      Some science writers are not careful in what they write. David is.

       

      I think basically what this case study shows is that it's possible to have normal fasting BGs and high postprandial levels, which most of us have known for a long time. And A1cs of 6.1 and 6.2 are not normal. My endo says when she sees an A1c of 5.7 she knows the person is diabetic.

       

      And a recent study showed that children who have fasting levels of 87 or more are likely to become diabetic when they get older.

       

       

       

    • heyjude
      Apr. 24, 2010

      Gret

    • heyjude
      Apr. 24, 2010

      aaaiiiieeeeee!!! I think there are mean gremlins in my computer!!!

       

      Gretchen, what is the 'normal' range of fasting for children.

    • Gretchen Becker
      Health Guide
      Apr. 25, 2010

      Jude, I don't know offhand. But it wasn't far below the 87. As usual, I may be misremembering the exact numbers, so don't count on this being correct. Try googling it.

    • heyjude
      Apr. 25, 2010

      Well Wiki may not be the most scientific source but says:

       Age differences

      Children's blood sugar levels are often slightly lower than adults'. Overnight fasting glucose levels are below 70 mg/dL (3.9 mM) in 5% of healthy adults, but up to 5% of children can be below 60 mg/dL (3.3 mM) in the morning fasting state.[ As the duration of fasting...

      RHMLucky777

      Read More

      Well Wiki may not be the most scientific source but says:

       Age differences

      Children's blood sugar levels are often slightly lower than adults'. Overnight fasting glucose levels are below 70 mg/dL (3.9 mM) in 5% of healthy adults, but up to 5% of children can be below 60 mg/dL (3.3 mM) in the morning fasting state.[ As the duration of fasting is extended, a higher percentage of infants and children will have mildly low plasma glucose levels, usually without symptoms. The normal range of newborn blood sugars continues to be debated. It has been proposed that newborn brains are able to use alternate fuels when glucose levels are low more readily than adults. Experts continue to debate the significance and risk of such levels, though the trend has been to recommend maintenance of glucose levels above 60-70 mg/dL after the first day after birth.

    • David Mendosa
      Health Guide
      Apr. 25, 2010

      Good point. I absolutely agree.

       

      David

  • Sandie
    Apr. 23, 2010

    It seems ridiculous to me that the medical community is so desperate for a cure to diabetes that they would latch onto gatric bypass.  The results of bypass surgery is hopefully just weight loss but that does not equate to increased health.  If a person is diligent in their diet and exercise, they can obtain the same results as this post-bypass...

    RHMLucky777

    Read More

    It seems ridiculous to me that the medical community is so desperate for a cure to diabetes that they would latch onto gatric bypass.  The results of bypass surgery is hopefully just weight loss but that does not equate to increased health.  If a person is diligent in their diet and exercise, they can obtain the same results as this post-bypass patient did.  As a matter of fact, my last fasting glucose was 57 by skin prick and on another occasion 65 by blood sample done in the lab, and my a1c is in the low 6s,  I am still obese and I'm working on it,  However, I cannot bring myself to take the easy way out of surgery that ends up failing several years down the line many times any way.  I'd be stuck having to deal with the same problem all over again.  It can also cause malnutrition; and I don't need to deal with that.  Why should a patient be cut up and mutilated in order to obtain a "cure" to diabetes?  Is that what medicine is coming to?

  • Gracie
    Apr. 23, 2010

    I'e "cured" my type 2 diabetes by eating low carb. And no complications, except I've lost a great deal of weight. That's a side effect I can embrace.

    Hugs,

    Gracie

    • Aggie
      Apr. 24, 2010

      How low carb do you go?

  • Aggie
    Apr. 23, 2010

    It really amazes me that everyone seems to assume that the disease = the high numbers. What if all these treatments just lower the numbers, but do not affect the underlying disease nor prevent long term complications?

     

    Bariatric surgery lowers the numbers. Whether it prevents the horrible complications associated with diabetes remains to be seen.

     ...

    RHMLucky777

    Read More

    It really amazes me that everyone seems to assume that the disease = the high numbers. What if all these treatments just lower the numbers, but do not affect the underlying disease nor prevent long term complications?

     

    Bariatric surgery lowers the numbers. Whether it prevents the horrible complications associated with diabetes remains to be seen.

     

    Before anyone would decide on such a course of action, they need to find out all that they can and not just listen to those promoting and doing the surgery. (not you, David, you seek the facts whether they agree with conventional wisdom or not).

     

    http://junkfoodscience.blogspot.com/2008/09/no-evidence-that-bariatric-surgeries.html

     

     

    • My Bariatric Life
      Health Guide
      Sep. 05, 2012

      You may find this of interest: One study investigated the rate of type 2 diabetes remission after gastric bypass and banding and the reasons leading to remission of type 2 diabetes after bariatric surgery. It showed gastric bypass being significantly more successful than gastric banding.

       

      http://www.medscape.com/viewarticle/733691

       

      Despite...

      RHMLucky777

      Read More

      You may find this of interest: One study investigated the rate of type 2 diabetes remission after gastric bypass and banding and the reasons leading to remission of type 2 diabetes after bariatric surgery. It showed gastric bypass being significantly more successful than gastric banding.

       

      http://www.medscape.com/viewarticle/733691

       

      Despite similar weight loss, 72% of bypass versus 17% of banding patients sustained remission of their diabetes three-years following the surgeries.

       

      -MBL

  • Venkat
    Apr. 23, 2010

    David,

     

    Thanks for this post.

     

    Have you heard of this one - Duodenal Bypass procedure? Apparently this is also being touted as solution to Type II diabetes.

     

    Thanks

     

    ~ Venkat

    • David Mendosa
      Health Guide
      Apr. 24, 2010

      Dear Venkat,

       

      Sorry, but I don't know about that procedure.

       

      David

    • David Mendosa
      Health Guide
      Apr. 24, 2010

      Dear Venkat,


      Sorry, but I don't know about that procedure.


      David

    • marksyd
      Jun. 01, 2010

       

      Venkat: There is a surgical procedure - duodenal exclusion (duodenal exclusion with a loop duodenojejunostomy) - for non-obese (overweight, slightly overweight or in the normal category) people with a BMI of under 30 suffering from Type 2 diabetes which is being done in Costa Rica which has eliminated Type 2 diabetes with an 80-90% success It involves...

      RHMLucky777

      Read More

       

      Venkat: There is a surgical procedure - duodenal exclusion (duodenal exclusion with a loop duodenojejunostomy) - for non-obese (overweight, slightly overweight or in the normal category) people with a BMI of under 30 suffering from Type 2 diabetes which is being done in Costa Rica which has eliminated Type 2 diabetes with an 80-90% success It involves removing or bypassing part of the upper small intestine or duodenum, so that food from the stomach goes directly into the lower small intestine - most importantly, removing the duodenum from the nutrient flow.

      This surgery is done laparascopically. But unlike the gastric sleeve, the stomach is not touched. Stomach volume is kept intact, maintaining the caloric ingestion so that in many instances, the patient undergoing duodenal exclusion will lose less than 5% of her/his pre-op weight, eliminating potential nutritional zig-zags and drastic dietary changes that may follow other types of bariatric surgery.

      The impact of this procedure on overweight, slightly overweight or normal-weight diabetes patients can be dramatic. Some patients find that within a few days of duodenal exclusion, they no longer need diabetes medication; others take just over a month to end dependence. In addition, this health-bringing change usually occurs with no weight loss. One preliminary study of just under 100 overweight (but non-obese) or slightly overweight patients who had undergone duodenal exclusion showed that over a 9-12 month period, almost 80% had a complete remission or great improvement of their Type 2 diabetes, independent of their weight loss or gain over the period examined. Some actually gained weight, but still remained diabetes free.

      Two large-scale trials published in the summer of 2009 in the New England Journal of Medicine have shown that patients who underwent a duodenal exclusion had a 92% reduction in diabetes-associated death.

      The duodenal procedure does not require much active follow-up participation on the part of patients. Patients can get back to normal life very quickly, and maintain a virtually normal diet with almost no restrictions on the types of food that they can eat.

      Not everyone with a BMI under 30 is eligible for this surgery. If you think you are in this category and are considering bariatric surgery to cure Type 2 diabetes, contact me.

       

    • jack hoyler
      Dec. 25, 2010

      Hello,

       

      I am very interested in the bariatric surgery specifically the duodenal exclusion w loop that may correct type II diabetes in non obese person(s).   I am non insulin dependent however I do take oral medications at this point in time.  I am 46 years old and in otherwise excellent physical condition. 

       

      Any assistance that...

      RHMLucky777

      Read More

      Hello,

       

      I am very interested in the bariatric surgery specifically the duodenal exclusion w loop that may correct type II diabetes in non obese person(s).   I am non insulin dependent however I do take oral medications at this point in time.  I am 46 years old and in otherwise excellent physical condition. 

       

      Any assistance that you can supply me regarding the above procedure would be greatly appreciated.  I reside in the Cleveland Ohio area and hopeful that the procedure may be being conducted in that area of the state.

       

      Sincerely,

       

      Jack

       

      www.jacksfeline@yahoo.com

    • Anonymous
      mrd
      Sep. 05, 2012
      Sorry to learn of your diabetes. Try to eat a low fat and sodium diet. Meet with a nutritionalist and exercise regularly. Try cinnamon in coffee and tea:)
    • My Bariatric Life
      Health Guide
      Sep. 05, 2012

      It is not the bariatric surgery in and of itself that "cures" diabetes. But rather it is the weight loss that can put diabetes into remission. There is no cure for diabetes but it can be controlled with weight loss, a grain-free diet, and exercise.

    • My Bariatric Life
      Health Guide
      Sep. 05, 2012

      Venkat, It is called a duodenal switch and you can read about it on HealthCentral Obesity here: http://www.healthcentral.com/obesity/c/276918/148264/bariatric-switch