Friday, April 1, 2011

Gastric Bypass as a “Cure” for Diabetes

I find fascinating reports that gastric bypass procedures “cure” roughly 80% of obese diabetics. Even before diabetics start losing weight or shortly thereafter, they go off insulin, have a drop in their blood sugars, and experience declines in their hemoglobin A2 levels.

What’s going on here? Is there some mysterious hormone in the gastric mucosa that triggers and sustains diabetes? Why do these procedures work in some patients and not in others? Would the procedures work in non-obese diabetics? How common are the complications, re-do’s, and deaths secondary to bariatric procedures? Does the cost of the procedures exceed the cost of treating diabetes in the long run?

With the number of diabetics in America approaching 20 million, even more pre-diabetics sitting in the wings, and more and more kids developing type 2 diabetes, we desperately need answers.

According to Population Health Metrics, total diabetic prevalence (diagnosed and undiagnosed cases) will increase from 14% of the population now, to 21% by 2050.

I can foresee costs of performing bariatric procedures on millions of diabetics exceeding the costs of cataracts, hip and knee replacements, back surgeries, and cardiac stents and pacemakers combined.

In any event, it seems to me, the causative factors behind these diabetic “cures” in significant numbers of diabetic undergoing bypass and gastric band procedures is worth more intensive research.

When is a cure a cure?
How can you be sure?
What if a procedure cures sometimes,
but for unknown reasons or rhymes,
What if diabetes comes back,
when weight returns back?
When does a temporary remission,
qualify as a path to total abolition?
Until those questions are answered,
The cure mystery remains unanswered.

4 comments:

Michael Kirsch, M.D. said...

Richard, here are some of my thoughts. http://bit.ly/d7BgDP

Best, MK

Weight said...

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www.segovia-3d.com said...

This cannot succeed in reality, that is exactly what I suppose.

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