Stomach-bypass surgery can reverse diabetes, research shows
In one study, gastric-bypass surgery put 75 percent of patients into full remission from diabetes, while a more extreme type of surgery led to a 95 percent remission rate.
The Washington Post
Stomach surgery can reverse Type 2 diabetes even in people with severe disease, reducing or eliminating their reliance on insulin and other medicines, two highly anticipated studies reported Monday.
Surgery or surgery combined with medication helped patients more than medicine alone, the studies also found.
With the number of diabetes patients soaring in the United States, physicians are searching for new ways to combat the expensive, chronic disease that can lead to strokes, foot amputations, blindness and other problems that can reduce life expectancy by a decade or more.
The studies tested three types of surgery that reduce the size of the stomach and bypass part of the small intestine.
In the first study, conducted at the Cleveland Clinic, some 40 percent of patients who had surgery had much better control of their blood sugar, while just 12 percent of patients who did not have the operation obtained that good outcome.
The second study, conducted in Italy, achieved even better results. Gastric-bypass surgery put 75 percent of patients into full remission from diabetes, while a more extreme type of surgery that bypasses more of the intestines, biliopancreatic diversion, led to a 95 percent remission rate.
"With these operations, we could take people with diabetes who are just barely obese ... and put diabetes in full remission," said surgeon Thomas Magnuson of Johns Hopkins University School of Medicine in Baltimore, who was not involved in either study.
Heather Britton of Bay Village, Ohio, is one success story. The 57-year-old computer programmer watched relatives succumb to early deaths from the disease. And as her own diabetes progressed, her physicians heaped on medications for high cholesterol and high blood pressure on top of her diabetes pills. And yet, her blood sugar stayed high, wrecking the mental focus she needed at her job.
"It was raging out of control," she said of her diabetes. "I felt like I was going down a predetermined path like mother and grandmother, just waiting for my stroke to happen."
Britton had never heard of surgery for diabetes until her physician told her about the Cleveland Clinic study. Her body mass index of 35, which is considered obese, made her eligible.
Britton had gastric bypass surgery in January 2009. By April, her doctors had taken her off all of her medications. She also began walking five days a week and eating less. She lost 80 pounds.
"It was awesome. I was feeling much better," she says.
The downside: For Britton, certain foods, including milk, peanut butter and yeast, trigger unpleasant symptoms, like hot flashes and diarrhea — a potential side effect of the surgery.
Insurance coverage of surgery for diabetes is not universal. Most plans offer it, but others don't. Medicaid will cover it if it is deemed "medically necessary," but definitions of that vary by state. Besides reducing caloric intake and helping patients drop weight, stomach surgery also triggers hormonal changes that help patients better control blood sugar, Magnuson said.
"Some people will say it's an extreme solution," said Steven E. Nissen, a Cleveland Clinic cardiologist involved in the study there. "But it's an extreme problem."