Gastric bypass: Is it a diabetes fix?

[bananas]

Gastric bypass: Is it a diabetes fix?

Within days of various weight-loss surgeries, blood sugar levels become easier to manage -- or are normal.

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As many as 86% of obese people with Type 2 diabetes find their diabetes is gone or much easier to control within days of having weight-loss surgery, according to a meta-analysis of 19 studies published earlier this year in the American Journal of Medicine (78% of patients with a remission of diabetes and 86.6% with remission or improvement). But experts still aren't sure why obesity surgery helps resolve Type 2 diabetes or how long the effect might last. And they disagree on how big a role surgery should take in treating the illness.

"We are going from seeing the results to understanding why it happens," said Dr. Santiago Horgan, director of the Center for the Treatment of Obesity at UC San Diego.

This much is clear: Patients who have weight-loss surgery begin to lose weight rapidly, which by itself improves Type 2 diabetes, allowing diabetics to more easily control their blood glucose levels. But something else appears to be occurring as well.

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[Warpy]

1. Whether the diabetes causes the obesity or the obesity

causes the diabetes is a source of much debate.

It is proven, however, that exercise and weight loss coupled with diet can greatly reduce or eliminate the need for medication in Type II diabetics.

Unfortunately, it's not a cure. Type II diabetes is a chronic and progressive disease. It can be controlled but never cured.

[Scout]

2. i think that the difficulty one has in controlling their weight

is the first SYMPTOM of already having Type II diabetes.

based on my purely anecdotal and personal experiences of my family and friends.

all the type ii diabetics i know had difficulty with weight gain starting at or soon after adolescence. :shrug:

i've never seen a fat type i diabetic ... they can't keep weight on, and the type ii's can't keep it off.

[noiretextatique]

3. diagnosed with type 2 in july and went on a diet

i've lost 40lbs. i had difficulty with portion size and eating the wrong types of food. i saw a nutritionist who gave me a 1500 cal/day diet that i stick to...for the most. now that i am on metformin, i am losing more weight.

[Scout]

9. so you had some difficulty controlling and/or losing weight....

but now that you are on the metformin it's easier.

so something about diabetic bodies/metabolisms doesn't want to lose weight on its own with diet and exercise. makes sense to me ... problem with weight gain and difficulty losing are the first symptom of type ii diabetes i think. it's not that you get fat and give yourself the disease.

[noiretextatique]

4. the key is weight loss, not necessarilty surgery eom

[bobburgster]

6. If you read on in the article

It says it actually seems to be the surgery, and only the bypass type of surgery.

[noiretextatique]

8. yep...i did see that

but i don't think those surgeries are necessary either, at least not for me diet and exercise = weight loss = lower glucose levels. the science is intriguing, certainly for people with more advanced diabetes than i have.

[TNDemo]

5. There is less food going into their stomach,

so the lower glucose levels make sense.

[Chemisse]

7. More from the article, pretty intriguing

There is strong evidence that surgery -- especially gastric bypass surgery, which makes the stomach smaller and allows food to bypass part of the small intestine -- causes chemical changes in the intestine, says Dr. Jonathan Q. Purnell, director of the Bionutrition Unit at Oregon Health & Science University. The small intestine has been thought of simply as the place where digestion occurs.

But researchers now suspect it has other functions related to metabolism. Surgery somehow alters the secretion of hormones in the gut that play a role in appetite and help process sugar normally.

Multiple studies in humans and animals indicate that surgery triggers reductions in ghrelin, the hormone that stimulates hunger, and elevates levels of peptide YY and glucagon-like peptide-1, both of which act as appetite suppressants. Another theory is that surgery might alter the expression of genes that regulate glucose and fatty-acid metabolism.