Possible Cure for Type 2 Diabetes
Written by Faith Anderson on March 27, 2012
A Hope for Diabetes Remission
“It’s an unprecedented effect that we’ve never seen in diabetes before,” says surgeon Dr. Francesco Rubino, senior author of the NEJM study and director of The Diabetes Surgery Center at New York-Presbyterian Hospital/Weill Cornell Medical Center. “Remission hasn’t even been a word in the textbooks about diabetes.” Doctors have been performing bariatric, or weight-loss, surgeries since the 1950s, and until now, the procedures have been considered just a treatment for morbid obesity. “The name ‘bariatric’ comes from a Greek term ‘baros,’ which means weight,” explained Dr. Rubino. “In the 1950s, there were anecdotal reports that diabetes disappeared after these surgeries, but it was considered a side effect of weight loss.”
Surgery vs. Medication for Diabetes Treatment
The two-year study, conducted by Rubino and researchers from the Catholic University/Policlinico Gemelli in Rome, Italy, and New York-Presbyterian Hospital/Weill Cornell Medical Center, compared bariatric surgery to traditional therapy for diabetics. Patients between the ages of 30 and 60 with severe type 2 diabetes were randomly assigned to three different treatment groups. One group received gastric bypass surgery, the second underwent bilopancreatic diversion surgery (BPD), in which part of the stomach is removed, and the third group received conventional treatment of medication and lifestyle and diet changes.
According to researchers, none of the patients in the third group went into remission, but patients who had surgery saw dramatic improvements in their condition. For 95% of group two, the BPD surgery forced their diabetes into full remission, and they were able to discontinue all diabetes medications. They were also able to maintain remission of their diabetes for the two-year study period. In comparison, 75% of the patients in group one, who all received gastric bypass surgery, went into remission.
Bariatric Surgery Could Send Diabetes into Remission
“We found that the change in the anatomy of the stomach and intestines can improve diabetes directly,” independent of the weight loss from surgery, said Dr. Rubino. “The stomach and intestine are not just there for absorption of nutrients. They also serve as an endocrine organ and make dozens of hormones. These hormones are directly relevant to the regulation of the body’s insulin.” While this means that even fit, non-obese diabetics may be eligible for bariatric surgery to cure diabetes, Dr. Rubino says that we’re not quite there yet. “I would not recommend the surgery for diabetic patients who are non-obese yet,” Rubino said, “but that’s the goal of the next few years.” For now, study authors recommend that physicians begin to consider weight-loss surgery as an alternative treatment to medication for diabetes in obese patients.