Weight loss surgery sends 50 per cent of type 2 diabetes patients into remission

[DCUK NewsBot]

A new study finds that bariatric (weight loss) surgery led to prolonged remission in half of patients with type 2 diabetes for at least five years. The trial, conducted by researchers from King's College London and the University Cattolica in Rome, tracked five-year outcomes of 53 obese patients with type 2 diabetes. Patients randomly underwent one of two types of bariatric surgery - gastric bypass and biliopancreatic - or continued with conventional medical therapy to control their type 2 diabetes. The study initially involved 60 patients. 20 underwent gastric bypass surgery, 20 underwent biliopancreatic diversion and the other 20 maintained standard drug therapy. 53 of the patients completed the study. Both gastric bypass and biliopancreatic diversion surgery involves reducing the stomach sizes of patients and leaving less of the intestines exposed to food. Half of the 40 patients who received bariatric surgery maintained remission from diabetes after five years. Remission meant that they no longer needed to take diabetes medication to keep their blood glucose levels stable. Furthermore, 80 per cent of surgery patients maintained optimal blood glucose control despite only taking one anti-diabetes medication or nothing at all, according to Professor Francesco Rubino. None of the 15 participants in the drug treatment group achieved remission, while patients in the surgery group still tended to have reduced blood glucose levels and used fewer diabetes and heart medications. "Treating surgically, rather than medical therapy, appears more cost-effective, as there is less use of medication," said Rubino, who added that the results were "remarkable". Long-term benefits The researchers observed that some patients relapsed in the final three years of the study, and that results in regard to diabetes remission were more successful in the two years after surgery. While gastric bypass and biliopancreatic diversion surgery have high success rates, there are a number of health risks associated with the procedures. Patients frequently need to take vitamin and mineral supplements for the rest of their lives as a direct consequence of the effects of surgery. Earlier this year, an Israeli study reported their doubts over the long-term benefits of bariatric surgery. This was due to weight loss and remission rates declining in patients over time. Lead researcher of this study, Dr. Keidar, highlighted that lifestyle changes are essential following weight loss surgery. Rubino also added that continual monitoring of blood sugar levels was required following the operation, to ensure that patients do not exit remission. In November 2014, the National Institute for Health and Care Excellence (NHS) advised that with obesity-related type 2 diabetes.

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[Oedett]

This can be done by fasting with out the high risk surgery see Dr Jason Fung You Tube A Canadian kidney doctor reversing type 2 diabetics

 

[Indy51]

And how peeved would you be if you are one of the 50% that it doesn't work for?

 

[Patch]

And how peeved would you be if you one of the 50% that it doesn't work for?

I'd be fuckin' furious!!!

It does make you think, though. Dr. Fong (quite a coincidence that he should show up here - because I watched some of his vids just yesterday...) talks a lot about glycogen stores, and the fact that excess sugar is not stored/converted to glycogen in the liver in diabetics, but that it "spills over" into the blood (and stays there!).

Now - this makes me think... What actually happens AFTER bariatric surgery in diabetics that causes either:

1) The Liver to release the glycogen that it is holding onto (freeing it up to take up more sugar, thus keeping BG's lower), or;
2) The mechanism that signals the Liver to store glycogen to STOP making that signal, allowing the Liver to release stored glycogen, and thus freeing up "space" in the Liver to take in more of the sugar that would usually (in the diabetic) "spill over" into the blood stream.

The more I think about it, I can't help but believe that T2 Diabetes is a disease of the Liver, or of the hormones that signal the liver to come OUT of "saving" mode, and into "spending" mode...

Intermittent Fasting has been on my radar for a while (but I am yet to try it). My fear with IF, is that it seems that one of the many issues that T2's face, is that the digestive system seems to be in an extended state of "storage mode" (Fast vs. Feast). My worry with that, is that fasting could actually re-enforce the bodies resolve to remain in "storage mode", and that fasting may actually be the trigger to put the body INTO storage mode.

Now - if that is the case, then it makes sense that REGULAR (and maybe even extended) fasting is the solution to this problem. But then we have to understand, that if that is the case, then we actually REALLY HAVE discovered the flaw in the system, and understand the that the way to work with the system in it's current state, is to go through periods of fasting.

My problem with that (as an ex-engineer) is that we are one step AWAY from the solution. We're not FIXING the system, we're implementing a work-around to try to ensure that they system as it is (broken) will still give us the required output (normal BG's).

In engineering, this would be seen as temporary, since we do not know what other issues that temporary fix would introduce.

In diabetes, we should be worried about the long-term effectiveness of this "solution". Because, another one of my worries, is that the diabetic body will adapt to this new level of fasting, and will find a way to return to it's own (incorrect) "normal" level of BG.

Thoughts? I'd love to get into conversation on this topic.

 

[Indy51]

@Patch - 16/8 intermittent fasting has been working a treat for me. There are a couple of long threads about fasting and IF elsewhere on the forum:

http://www.diabetes.co.uk/forum/threads/fasting-for-type-2s.73800/
http://www.diabetes.co.uk/forum/thr...g-14-10-16-8-5-2-24-hr-fast-20-hr-fast.79549/

 

[ButtterflyLady]

This can also be done with LCHF. No need for risky surgery. I wish people were told about this option before they choose surgery.

 

[phoenix]

Professor Taylor's 'diet 'intervention is meant to mimick what happens in weight loss surgery; because of course the results occur before the weight loss.
What will be significant is if his long term trial produces the same results over two years and indeed how many people are able to be 'adherent'

 

[andcol]

Intermittent Fasting has been on my radar for a while (but I am yet to try it). My fear with IF, is that it seems that one of the many issues that T2's face, is that the digestive system seems to be in an extended state of "storage mode" (Fast vs. Feast). My worry with that, is that fasting could actually re-enforce the bodies resolve to remain in "storage mode", and that fasting may actually be the trigger to put the body INTO storage mode.

Now - if that is the case, then it makes sense that REGULAR (and maybe even extended) fasting is the solution to this problem. But then we have to understand, that if that is the case, then we actually REALLY HAVE discovered the flaw in the system, and understand the that the way to work with the system in it's current state, is to go through periods of fasting.

My problem with that (as an ex-engineer) is that we are one step AWAY from the solution. We're not FIXING the system, we're implementing a work-around to try to ensure that they system as it is (broken) will still give us the required output (normal BG's).

Fasting worked for me on a very low calorie diet for many months along with walking on the treadmill or around the streets to keep my glucogen stores low.

Intermittent fasting is what we are designed for. Evolutionarily we really had intermittent feasting with our normal state being fasting. So the only system that is broken is society. Fix that and fix the problem