Weight-Loss The Only Way To Cure Diabetes
Biomed Middle East, 24th February 2010
In the majority of cases patients with diabetes are obese or overweight. There are cases, though, when patients are not obese but suffer from the disease. On the other hand, there are also obese but diabetes-free patients.
This is one of the reasons why the BMI factor should be discussed as the only way to decide who is eligible for the weight-loss surgery.
Over 20 years ago BMI became a parameter of eligibility for weight-loss surgery. It makes sense to take BMI into consideration when selecting patients for the procedure aimed at weight loss but this factor becomes discriminatory when it comes to the patients with diabetes.
“As an alternative,” Says Dr. Francesco Rubino from the New York-Presbyterian Hospital, “patients should be triaged based on the severity of their disease, their metabolic profile, and other predictors of cardiovascular disease risk).
Type 2 diabetes is a disease that affects over 200 million people worldwide. Many of them have complications affecting kidneys, eyes, heart and extremities. In most cases treatments as diet, medications and insulin, are ineffective.
Dr. Rubino agrees that diet and exercise can prevent the disease and they are extremely important in the health care policy and planning. Unfortunately the life-style and diet have little impact on the advanced disease.
“Telling a patient with severe diabetes to eat low-fat diet and go to the gym Is comparable to telling the person with lung cancer to stop smoking,” says Dr. Rubino.
There are numerous advantages of the bariatric surgery: straight after the procedure the diabetes improve immediately, very often to the point of complete remission.
Researches have shown that removing portions of the jejunum or duodenum – the upper part of the small intestine below the stomach – leads to improvements or even diabetes cure. Also inserting a tube in that part of intestine which allows food to pass through without coming into contact with the area, has the same effect. When food passes from the stomach into the upper end of the small bowel, a mix of hormonal reactions causes diabetes. That is why it is so important to understand those reactions precisely.
More and more surgeons reckon that weight-loss surgery has a crucial role in curing diabetes. In the November 2009 publication in the Diabetes Care, 12 clinical experts published a consensus statement that defines remission and cure.
Dr. Rubino says: “The statement implicitly recognizes that remission is achievable only by surgery. It states that remission exists when normal glycemia is obtained in the absence of medical therapy; hence, by definition, medical treatment cannot achieve remission”.
