The possibility that bariatric surgery could cure diabetes emerged about a decade ago.
A long-term study of thousands of patients in Sweden reported in 2004 that both gastric bypass and banding improved diabetes in many subjects.
A 2008 study of 55 obese patients found that 73 percent of those who underwent gastric banding saw their diabetes disappear after two years, compared to 13 percent undergoing standard medical treatment such as medication, diet and exercise.
In 2009, surgeons at the University of Minnesota analyzed 621 mostly small studies of bariatric surgery in obese, diabetic patients. Their conclusion, reported in the American Journal of Medicine: 78 percent no longer needed medication to control their blood sugar. They’d been cured. Lap banding had the worst results, worsening diabetes in some patients.
But most patients in these studies were obese, many morbidly so. (The average BMI was 48.) The improvement in glucose control could therefore be credited to the patients’ weight loss, which averaged 85 pounds.
Dr Francisco Rubino had a hunch that something else was at work. As a research fellow in diabetes at Mount Sinai Hospital in New York in 1999, he was reviewing the medical literature one day for guidance on how to best perform bariatric surgery on a man with a BMI of 80. He found papers from the 1950s and earlier reporting that surgery for peptic ulcers had cured diabetes.
A year ago, Rubino began the first large study for type-2 diabetes patients with a BMI as low as 26, where “overweight” begins. He modified the popular gastric bypass surgery, called Roux-en-Y.
Filed Under: Health & Fitness