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Chicago - Obesity Surgery-Diabetes Study Shows Pros, Cons

Published on: June 4, 2013 11:41 PM
By: AP
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(AP Photo/Joerg Sarbach)(AP Photo/Joerg Sarbach)

Chicago - Obesity surgery worked much better at reducing and even reversing diabetes than medication and lifestyle changes in one of the most rigorous studies of its kind. But the researchers and others warn that possible serious complications need to be considered.

The yearlong study indicates that the most common weight-loss surgery, gastric bypass, can effectively treat diabetes in patients with mild to moderate obesity - about 50 to 70 pounds overweight, the researchers reported Tuesday in the Journal of the American Medical Association.

Other studies have shown the operation can reverse diabetes in severely obese patients, although sometimes the disease comes back.

About a third of the 60 adults who got bypass surgery in the new study developed serious problems within a year of the operation, though some cases were not clearly linked with the surgery. That rate is similar to what’s been seen in previous studies.

But for the most serious complications - infections, intestinal blockages and bleeding - the rate was 6 percent, slightly higher than in earlier research.

The most dangerous complication occurred in one patient when stomach contents leaked from the surgery site, leading to an overwhelming infection, leg amputation and brain injury. Lead author Dr. Sayeed Ikramuddin, an obesity surgeon at the University of Minnesota, called that case “a fluke.”

A journal editorial says such devastating complications are rare, but that “the frequency and severity of complications ... is problematic” in the study and that the best way to treat patients with both obesity and diabetes “remains unknown.”

A research review in the journal said more long-term evidence on risks and benefits is needed to determine if obesity surgery is an appropriate way to treat diabetes in patients who aren’t severely obese - at least 100 pounds overweight.

More than 20 million Americans have Type 2 diabetes; most are overweight or obese. Diabetics face increased risks for heart disease and strokes, and poorly controlled diabetes can damage the kidneys, eyes and blood vessels.

About 160,000 people nationwide undergo various types of obesity surgery each year. Bypass surgery, the type studied, involves stapling the stomach to create a small pouch and attaching it to a lower part of the intestines.

The American Society for Metabolic & Bariatric Surgery says obesity surgery is safe and that the death rate is less than 1 percent, lower than for gallbladder and hip replacement surgery.

The study involved 120 patients at five hospitals in New York, Minnesota and Taiwan. All patients got medicines for diabetes, obesity, cholesterol and/or high blood pressure. They all were advised to cut calories and increase physical activity.

Sixty patients also had surgery, and the two groups were compared after one year.

The surgery group lost on average nearly 60 pounds and 75 percent lowered blood sugar levels to normal or near normal levels. The non-surgery group lost an average 17 pounds and just 30 percent reached the blood-sugar goal. The surgery group also needed less medication after the operation.

The researchers say the diabetes changes were likely due to the weight loss but that hormonal changes affecting blood sugar may have contributed.

The surgery group showed a trend toward having less high blood pressure and elevated cholesterol - both major risk factors for heart disease, although those between-group differences could have been due to chance.

Ikramuddin, the lead author, said the study results don’t mean that all mildly obese diabetics should have obesity surgery, but that “in the correct patient, surgery might be an important thing to consider.”


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Read Comments (8)  —  Post Yours »

1

 Jun 05, 2013 at 08:50 AM murray059 Says:

I think I know the gentleman in the picture.

2

 Jun 05, 2013 at 09:32 AM Geulah Says:

Prevention!?! Neshartem nafsheco meod!?! Is exercise and eating well assur? I'm a diabetic and I'm 15 lbs overweight, today. I've exercised, using weights, bicycling and plain walking. What happens, when it's not ingrained as a habit you lose the darfkeit to go do it. I started up again, I'm sick of the medications and their egregious prices. The amount of money that I have to give over for drugs to control diabetes is insane. When I take off 15 lbs of fat and add 15 lbs of muscle and make my health as important as going to daven, shiur, or some mosdos dinner, I won't need the drugs. Think I'm wrong. I've been there. There is no magic pill or life lengthening procedure that substitutes for common sense.

3

 Jun 05, 2013 at 09:56 AM heavyweight Says:

Our lifestyle, especially a frum one, does not afford much time for leisure, to permit enough, or any, exercise.

4

 Jun 05, 2013 at 12:18 PM Anonymous Says:

Reply to #2  
Geulah Says:

Prevention!?! Neshartem nafsheco meod!?! Is exercise and eating well assur? I'm a diabetic and I'm 15 lbs overweight, today. I've exercised, using weights, bicycling and plain walking. What happens, when it's not ingrained as a habit you lose the darfkeit to go do it. I started up again, I'm sick of the medications and their egregious prices. The amount of money that I have to give over for drugs to control diabetes is insane. When I take off 15 lbs of fat and add 15 lbs of muscle and make my health as important as going to daven, shiur, or some mosdos dinner, I won't need the drugs. Think I'm wrong. I've been there. There is no magic pill or life lengthening procedure that substitutes for common sense.

Not everyone is like you. You were different than those studied- you werent as heavy- you arent even obese!
If you read the study, it said it isn't appropriate for everyone but surgery does seem to have great benefits. I know someone who is basically a non diabetic now (rarely gets highs and lows and is off meds) and lost like 200 pounds from this surgery. If someone has another disease that stops them from exercising then this may be their best option.

5

 Jun 05, 2013 at 01:33 PM Geulah Says:

Reply to #3  
heavyweight Says:

Our lifestyle, especially a frum one, does not afford much time for leisure, to permit enough, or any, exercise.

Anyone can spend 20 minutes, 3 times a week to exercise and get, over the course of a year, more in shape. If we can find time to go to 7 kiddushes over a Shabbos, we can find an hour a week to exercise. Regarding the bitul zman chevrah, there's no bitul zman in exercise unless there's bitul zman in eating and sleeping.

6

 Jun 05, 2013 at 03:00 PM sane Says:

Reply to #5  
Geulah Says:

Anyone can spend 20 minutes, 3 times a week to exercise and get, over the course of a year, more in shape. If we can find time to go to 7 kiddushes over a Shabbos, we can find an hour a week to exercise. Regarding the bitul zman chevrah, there's no bitul zman in exercise unless there's bitul zman in eating and sleeping.

We don't work on Shabbos, which is why there is more time - but you cannot go to the gym on Shabbos. We do work hard during the week, we daven with a minyan, we have sedorim in the morning and at night in learning, we do homework with children, we attend to social and communal obligations. There is little, if any, time left for a formal exercise program.

7

 Jun 05, 2013 at 06:50 PM Anonymous Says:

Reply to #6  
sane Says:

We don't work on Shabbos, which is why there is more time - but you cannot go to the gym on Shabbos. We do work hard during the week, we daven with a minyan, we have sedorim in the morning and at night in learning, we do homework with children, we attend to social and communal obligations. There is little, if any, time left for a formal exercise program.

Where there is the will, there is the time.

8

 Jun 05, 2013 at 08:28 PM kraush Says:

All you people that say its impossible for a jewish lifestyle, check out www.kosherchallenge.com

I just started the kosher challenge w/o taking the shake!

9

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