Gastric bypass surgery as T2 'cure'?

Irritating news article that went out on the BBC website today.

Essentially, it's the story of how an obese, overeating truck driver was 'cured' of Type 2 after gastric bypass surgery.

Interestingly the claim of a 'cure' was made by the doctor who carried out the weightloss surgery.

Here we go again!

This is actually documented all over the place as a possibility for many T2s. Dan Hurley even writes about this in his book ‘Diabetes Rising’.

Here’s an article that explains better why this seems to work in some people (aka the technical stuff about hormones and digestion): http://www.sciencedaily.com/releases/2008/03/080305113659.htm

I’m not saying it’s a cure for everyone, but it does seem that there is a lot out there about how people were able to go off oral meds or reduce insulin within days of GB surgery, before weight loss occurred.

I know it won’t work for everyone, especially because the causes of T2 are so illusive and there’s no cut and dry ‘this is what causes it, this is what could cure it’. But it seems it’s an option for SOME T2 diabetics. I have a problem with the media making it out to be a cure for EVERY T2 though!

I'm not saying it's a cure for everyone, but it does seem that there is a lot out there about how people were able to go off oral meds or reduce insulin within days of GB surgery, before weight loss occurred.

Yes it seems they get there 1st phase insulin response back.

"In some individuals, the duodenum and jejunum may be producing too much of this anti-incretin, thereby reducing insulin secretion and blocking the action of insulin, ultimately resulting in Type 2 diabetes."

I find gastric bypass diabetic reversal fascinating as I am sure the research scientists do as well. As they delve deeper into these incretin signalling pathways they may open the door for a newer better byetta…

I know my weight loss ~72 lbs certainly helped my condition.

If people want to be “cured” through poor food absorption, malnutrition, and having dumping episodes all the time and hypoglycemia… well, then that’s their choice, isn’t it? lol But since my quality of life would be many times worse with this than it would be with the weight, and the Diabetes, then I’ll take my own ways of controlling it, thank you very much… Oh, and did they happen to mention that it’s a Russian Roulette? That it is NOT guaranteed that you will be “cured” in any way? lol Sadly, lots of people regain weight, too, when they have these little surgeries that really do nothing to re-educate their main problems to begin with… and then they really discover they were never cured to begin with. Quick fix solution it is NOT.

For some diabetics the results are phenomenal. In general the article is a bit too rosy. But many can cut insulin down to less than half. There is no doubt that there are extra benefits not accounted by weight loss only.

Yes

Wow! From 600u a day to 0 is amazing!

It’s too bad she’s developed osteoporosis and hypoglycemia, but compared to barely being able to move and having to take that much insulin I’m sure she feels better.

Although T2 diabetes is portrayed as being a condition where obesity causes insulin resistance, that is now known to be bogus. Certainly, increased bodyfat can result in insulin resistance, but we now know that it is much more complicated and there is much more going on. Ralph DeFronzo actually believes there are eight different defects involved with T2. One of those defects is the generation of incretin hormones, namely GLP-1 which signals the pancreas to secrete insulin in response to eating. It is thought that this surgery somewhat corrects this defect, but you have to ask, “what about the other seven defects?” In fact, there are now drugs that correct the secretion defect, Byetta and Victoza increase GLP-1 and Januvia and Onglyza suppress the DPP-4 which inhibits GLP-1.



In the end, I think it would be far more preferable to try Byetta and Victoza. If they don’t work, then you would have to really question whether bypass surgery would work.

Wow 600 to 0 that is remarkable.

I feel like I’m always learning something new from you!

thanks for the key words, off to study incretins.

There are two incretins GLP-1 and GIP. GIP is thought to be the reason for the dramatic reversal in diabetes and there are currently no drugs for GIP. Here is a site explaining the conundrum; point of interest you cannot do a copy/paste from this website it is short non technical and quite lucid.

http://www.cutthewaist.com/duodenal.html

I started Victoza about 5 months ago. My A1C went from 9.8 to 6.7 with just the Victoza. I take one injection daily and it is working for me. I am hoping my A1C will go down below 6.5 for my next visit.

Bypass surgery is permanent, plus I know several people who have had the surgery and then slowly start to regain the weight or have dietary complications. The point is that the bypass surgery doesn’t change eating habits and without that you will eventually gain back the weight. If you exercise and change your eating habits, why do the surgery?

You may enjoy a lecture from one of my favorite researchers, Ralph Defronzo. This talk is specifically about GLP-1 analogs.

Well, it’s a lot more complex than simply exercising and changing your eating habits. bsc explained it very nicely in his posts above.



An interesting side-note is that some companies are developing devices that mimic gastric bypass, but that are reversible, so if they don’t work, they can be removed. Gretchen Becker wrote about them:



http://www.healthcentral.com/diabetes/c/5068/126010/approaches-type-2





Yes I am a member of medscape will have to start using it more often.

The European Union has issued the CE mark of approval to GI Dynamics of Lexington, MA for its EndoBarrier device as a treatment option for obesity and type 2 diabetes. The device, which is implanted endoscopically via the mouth, essentially creates a chamber in the stomach and effectively limits the amount of food a patient can digest. The device is not intended for permanent placement and the approval stipulates its use for a six month therapeutic period.

http://medgadget.com/archives/2009/12/endobarrier_bypasses_gastric_bypass_for_obesity_diabetes_treatment.html

LOL there is no cure. Only treatments.

And bypass surgery is just another treatment.

A cure is something you take once that restores your existing body to a non diabetic state and keeps it that way.

Pills, shots, nano robots, surgery, supplements, etc are not cures. They are just treatments.

A cure would be a pill or a shot that ‘cures’ you. Leaves your body whole and self sufficient. One that allows you to eat and do anything you what, as much as you want, any time you want, with total impunity. A cure is something that fixes an existing problem and is only needed one time then it is out of your system.

Radiation is a cure for some cancers, or is it just a treatment?

About the weight loss surgery - that is not now or ever will be a cure. It is a treatment that brings about other problems.

Talk to people who have had the surgery. They can’t eat normally.

OMG!!! If I hear about bypass surgery being a “cure” one more time, I may blow up! No one removed these people’s pancreas, no one took their blood out and replaced it with difference blood. By pass helps people to lose weight, but it doesn’t cure, (as in take away forever diabetes) Sure the patient is going to see a downward swing in their BS numbers at the beginning, and maybe lower Bs’s for awhile, but, eventually, they will see the numbers go up — although not as high as when they weighed more — but they aren’t cured. My friend that had the bypass was fed that line of baloney from her doc, and she believed it. She is now 80 thinner, and back on her medications for her diabetes, wondering what went wrong. Nothing went wrong, she still has a pancreas that doesn’t function properly. Where do these docs get the right to lie to patients?