Two studies say surgery can halt Type 2 diabetes
CHICAGO — New research gives clear proof that weight-loss surgery can reverse and possibly cure diabetes, and doctors say the operation should be offered sooner to more people with the disease — not just as a last resort.
The two studies, released Monday, are the first to compare stomach-reducing operations with medicines alone for “diabesity” — Type 2 diabetes brought on by obesity. Millions of Americans have this and can’t make enough insulin or use what they do make to process sugar from food.
Both studies found that surgery helped far more patients achieve normal blood-sugar levels than medicines alone did.
The results were dramatic: Some people were able to stop taking insulin as soon as three days after their operations. Cholesterol and other heart risk factors also greatly improved.
Doctors don’t like to say “cure” because they can’t promise a disease will never come back. But in one study, most surgery patients were able to stop all diabetes drugs and have their disease stay in remission for at least two years. None of those treated with medicines alone could do that.
“It is a major advance,” said Dr. John Buse of the University of North Carolina at Chapel Hill, a leading diabetes expert who had no role in the studies. Dr. Buse said he often recommends surgery to patients who are obese and can’t control their blood-sugar through medications, but many are leery of it. “This evidence will help convince them that this really is an important therapy to at least consider,” he said.
There were signs that the surgery itself — not just weight loss — helps reverse diabetes. Food makes the gut produce hormones to spur insulin, so trimming away part of it surgically may affect those hormones, doctors think.
Weight-loss surgery “has proven to be a very appropriate and excellent treatment for diabetes,” said one study co-leader, Dr. Francesco Rubino, chief of diabetes surgery at New York-Presbyterian Hospital/Weill Cornell Medical Center. “The most proper name for the surgery would be diabetes surgery.”
The studies were published online by the New England Journal of Medicine, and the larger one was presented Monday at an American College of Cardiology conference in Chicago.
Tamikka McCray, 39, who lives in New York and works for the city’s Human Resources Administration, also had success from her surgery a year and a half ago. When she left the hospital, her diabetes had disappeared before any major weight loss had a chance to occur.
“That was the crazy part,” she said. “I didn’t understand that when they came in and they checked it. My sugars were normal.” She added: “I left the hospital with no medication. And I haven’t been on anything since.”
More than a third of American adults are obese, and more than 8 percent have diabetes, a major cause of heart disease, strokes and kidney failure. Between 5 million and 10 million are like the people in these studies, with both problems.
For a century, doctors have been treating diabetes with pills and insulin, plus encouraging weight loss and exercise with limited success. Few very obese people can drop enough pounds without surgery, and many of the medicines used to treat diabetes can cause weight gain, making things worse.