Re: Bariatric surgery is not a cure (because WE say so!)

kurtwheeling@xxxxxxxxx wrote:

The fact is that bariatric surgery for some - albeit a very select
group - may well be a cure for diabetes.

http://www.msnbc.msn.com/id/22787261/ns/health-diabetes/t/obesity-operation-may-cure-diabetes-many/

Kurt
"Coming Up Next; Shattering the myth that central heating is just like
the human body"



you are far too modest Kurt

bariatric surgery for some - albeit a very select
group - may well be a cure for diabetes.

Bariatric surgery is a cure for every one except for grumpy old actuaries and hysterical refrigerators :

Ann Surg. 2011 Apr;253(4):699-703.
Effects of biliopanceratic diversion on type 2 diabetes in patients with BMI 25 to 35.
Biliopancreatic diversion (BPD) resolves type 2 diabetes in near totality of morbidly obeses [BMI (body mass index) ≥35 kg/m]. However, studies of BPD effect in BMI range 25.0 to 34.9 kg/m, including about 90% of diabetic patients, are lacking.
MATERIALS AND METHODS: If BPD effects are independent of weight changes, they should be maintained in patients who, being mildly obese or overweight, will lose little or no weight after operation. Thirty type 2 diabetic patients with BMI 25 to 34.9 were submitted to BPD and monitored 12 months. Thirty-eight diabetic patients selected from a large database, kept 1 year on medical therapy, served as controls. RESULTS: Nineteen male and 11 female. Mean age 56.4 ± 7.4 years, weight 84.8 ± 11.1 kg, BMI 30.6 ± 2.9 kg/m, waist circumference 104 ± 9.4 cm, diabetes duration 11.2 ± 6.9 years, HbA1c 9.3±1.5. Twelve patients on insulin. Fifteen (2 F) with BMI < 30 (mean: 28.1). No mortality or major adverse events occurred. BMI progressively decreased, stabilizing around 25 since the fourth month, without excessive weight loss. One year after BPD, mean HbA1c was 6.3%±0.8, with 25 patients (83%) controlled (HbA1c≤7%) on free diet, without antidiabetics, and the remaining improved. Acute insulin response to intravenous glucose had increased from 1.2 ± 2.9 to 4.2 ± 4.4 μIU/mL. Diabetes resolution correlated positively with BMI. HbA1c decreased at 1 year in the control group, along with an overall increased amount of antidiabetic therapy.
CONCLUSIONS: BPD improves or resolves diabetes in BMI 25 to 35 without causing excessive weight loss, its action being on insulin sensitivity and beta-cell function. The strikingly different response between morbidly obese and low BMI patients might depend on different beta-cell defect. ClinicalTrials.gov Identifier: NCT00996294.
PMID: 21475009

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