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Surgery to Cure Diabetes?

C

Cowboyjim

Well-Known Member
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http://www.ivanhoe.com/channels/p_channelstory.cfm?storyid=29268
Brief piece with usual preamble about incurabality but then this quote:
"Surgery is probably the best way to treat diabetes," says Dr. Keith Kim, MD, FACS, director of Metabolic Medicine & Surgery Institute at Celebration Health and one of the speakers at the ASPN conference. "Gastric bypass surgery resolves diabetes and improves glucose intolerance," Dr. Kim adds. "There will be more studies of the mechanisms underlying the surgical resolution of diabetes," as well as, "a development of surgeries specifically tailored for treating diabetes."
Sadly no details... :|
 
Gastric bypass surgery resolves diabetes and improves glucose intolerance
Click to expand...


Just located a discussion where two bariatric practitioners talk about this.
(Drs Eric Westman and Mary Vernon)

http://www.thelivinlowcarbshow.com/show ... ary-vernon

If you start listening from 20 minutes in, you'll hear the relevant points.
Seems it works by FORCING the patient to eliminate carbs from their diet. Dr Vernon says carb intake will result in them being very sick, with cramps and diarrhoea.
They have to eat protein instead.

Carbs being the problem - where have I heard that before ?

Geoff
 
Can this not be achieved just by not having carbs? No need for surgery at all?

or am I being stupid again and missing something :oops:
 
It's a complex subject and from what I have read the doctors don't fully understand why it works, but they do know that is does work.

I would have it done tomorrow, but sadly my doc. will not cooperate!

H
 
Post operative diets aren't carb free though they tell people to avoid high sugar foods.
http://www.bospa.org/Information.aspx?Page=21

Some sorts of bypass surgery seem to be far more effective than others at reversing diabetes, duodenal switch surgery is reported as resolving diabetes in 98% of cases whereas gastric banding only 48%.http://jama.ama-assn.org/content/292/14 ... l.pdf+html

What is remarkable with some surgery is that in there are many cases where the diabetes is 'resolved' within a few days before any significant weight loss has occurred. It has been found to be successful with people (T2)who have been on insulin for some time. They don't know why it works as it does and there is a lot of research centred on the the signalling systems and hormones in the foregut.
They have 'cured' diabetic rats with a similar type of surgery that left the stomach volume the same.

All the same there are the normal risks of surgery. There is the additional problem that mal absorption means that the person may suffer flatulence and diarrhoea if they eat either too many simple carbs or too much fat.
 
And any surgery is more risky for a diabetic than for other people.

I'm pleased I've been able to achieve massive weight loss by... wait for it... choosing to eat less food.

:wink:
 
Gastric bypass surgery resolves diabetes and improves glucose intolerance
Click to expand...

Found another discussion of this, which links it to carbohydrate restriction (or carbohydrate-availability-to-the-body restriction)

http://www.carbohydratescankill.com/345 ... in-mystery

where it says :

"Bariatric surgery achieves the goal of preventing hyperglycemia by bypassing carbohydrate foods from the stomach to the very last part of the small intestine that denies most of the carbohydrate foods the chance of being digested by the pancreatic amylase to become monosaccharides for absorption by the small intestine, before entering the large intestine. Consequently, the patients who have received bariatric surgery are able to normalize and stabilize their blood glycemic level, and reduce their cardiovascular events."

And the same guy has an angle on Diabetes mellitus and sleep apnoea :

http://www.carbohydratescankill.com/145 ... mia-beyond

I found CatLadyNZ's point about sleep apnoea (on another thread)
viewtopic.php?f=2&t=28681
interesting, and I'll explore it further.
In the link above he claims that "restricting carbohydrate should help decrease stress hyperglycemia and the ill impacts of sleep obstructive apnea, which incidence diminishes as weight loss progresses."

With a book out called Carbohydrates Can Kill, it's no surprise he's pointing the finger at carbs again.

Whether I agree or not, it's interesting to read of the association with sleep apnoea, which I had not known about.
Thanks, Cat LadyNZ

Geoff
 
"Bariatric surgery achieves the goal of preventing hyperglycemia by bypassing carbohydrate foods from the stomach to the very last part of the small intestine that denies most of the carbohydrate foods the chance of being digested by the pancreatic amylase to become monosaccharides for absorption by the small intestine, before entering the large intestine.

Wouldnt not eating the carbohydrates in the first place have the same effect without the need for surgery?
Click to expand...
 
I read somewhere about a technique where people were hypnotised into believing they'd had baryatric surgery. they felt full after eating small portions and lost weight. I wonder if that would work on diabetes? If it doesn't, that's evidence for the effect being physical.
Hana
 
PS
I still suspect that the surgical "cure" for diabetes may simply be a remisssion caused by weightloss and low carb eating. If the person goes back to former ways of eating [ and I've heard of some people liquidising a MacDonald's meal!] would the condition re-establish itself?
Hana
 
Wouldnt not eating the carbohydrates in the first place have the same effect without the need for surgery?
Click to expand...

You're right, of course, but doctors can tend to think we're too stupid to do something properly ourselves.
Additionally, there seems to be some 'mystery' about how the surgery is effective. Surely it can't be to do with those health-enhancing carbohydrates we're advised to eat at every meal ?

I'd guess they'd be happier pushing a doctor-led cure, than advocating some dodgy low carb diet :(

Geoff
 
Hi Geoff

Thanks for the links - it's all very interesting. The approach most doctors take to sleep apnoea is the same as the approach most (UK and NZ) doctors take to T2 diabetes. They have it all around the wrong way.

Diabetes - they tell you to eat carbs with every meal, or they downplay the role of carbs, or they over-medicate and under-encourage patient self-management.

Sleep apnoea - they tell you simply losing weight will cure it, or it's caused solely by airway/neck anatomy or stress/depression, or they assume the ordinary type of CPAP therapy will work in every case, and they don't properly screen for related conditions like diabetes or early heart disease.

Bariatric surgery may help with both conditions, but it is worth the cost and risk, when other treatments may be cheaper and safer?

I have no doubt that if someone is clinically obese (BMI over 30), then weight loss of any kind will help manage either condition(s). It matters more that the person loses weight than how they do it. However, people should be adequately screened for both conditions, because optimising the therapy for each will make weight loss more likely, easier, cheaper, faster, and safer.

The IDF has a campaign aimed at trying to get doctors to check for sleep apnoea if someone has diabetes, and vice versa:
http://www.idf.org/sleep-apnoea-and-type-2-diabetes
 
All very interesting making me glad I posted this. A couple of things spring to mind.
It is ironic that there is all this fuss about DM costing the NHS so much - surely this surgery is very expensive?
I think there is a mindset that you are ill, they fix you, this fixing could be pills or surgery. This is how things have become in society. There is now a growing alternative of self-healing in some cases. In our cases it is more subtle, self-management for what we are resigned to be a life-long illness.
That said, I think I would advocate surgery in some cases for ex young people. I have afaik only had DM for 3 years, they face a lifetime of it... 8)
 
Young people have but one purpose - as mobile organ donors for us older types who are the only ones whoever achieve anything worthwhile and never moan about anything... :twisted:
 
librarising said:
Gastric bypass surgery resolves diabetes and improves glucose intolerance
Click to expand...


Just located a discussion where two bariatric practitioners talk about this.
(Drs Eric Westman and Mary Vernon)

http://www.thelivinlowcarbshow.com/show ... ary-vernon

If you start listening from 20 minutes in, you'll hear the relevant points.
Seems it works by FORCING the patient to eliminate carbs from their diet. Dr Vernon says carb intake will result in them being very sick, with cramps and diarrhoea.
They have to eat protein instead.

Carbs being the problem - where have I heard that before ?

Geoff
Click to expand...

Mary Vernon is the co-author of Atkins Diabetes Revolution, my favourite low-carb book for Type 2s (but useful for low-carbing Type 1s too!).

Viv 8)
 
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