Medical experts recognize WLS as legitimate treatment for type 2 diabetes

[MsJacquiiC]

A first-of-its-kind consensus statement by 50 medical experts from around the world has pronounced surgery to be a legitimate and effective treatment for type 2 diabetes, bringing the procedure a significant step closer to wider use and acceptance.

While more study has been recommended, [the consensus is that surgery is] an effective treatment for select patients with type 2 diabetes...

The report, recently published in the Annals of Surgery, illustrates the findings of the first Diabetes Surgery Summit (DSS), an international conference held at the Catholic University of Rome, Italy, where more than 50 scientific and medical experts agreed on a set of guidelines and definitions to guide the use and study of gastrointestinal surgery to treat type 2 diabetes.

"This is very good news for people in Qatar and other Gulf countries where diabetes continues to be a major health concern," says Bakr Nour, MD, professor of surgery at Weill Cornell Medical College in Qatar and vice chair of surgery at Weill Cornell Medical College in New York. "It is estimated that 15 to 20% of GCC nationals suffer from diabetes, though many may be unaware that they have it. The disease rates continue to rise both in adults and children, and prevalence among Qatari children has doubled in the past 10 years."

"While more study has been recommended, consensus about surgery as an effective treatment for select patients with type 2 diabetes means that many more patients will be considered as candidates for the procedure," says Dr. Nour. "It could mean a dramatic improvement in the quality of life for those patients for whom lifestyle changes and less invasive therapies prove insufficient."

"The recommendations from the DSS are an opportunity to improve access to surgical options supported by sound evidence, while also preventing harm from inappropriate use of unproven procedures," says the consensus paper's lead author Dr. Francesco Rubino, director of the gastrointestinal metabolic surgery program at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and associate professor of surgery at Weill Cornell Medical College.

The article in the Annals of Surgery summarizes the mounting body of evidence showing that bariatric surgery effectively reverses type 2 diabetes in a high proportion of morbidly obese patients, sometimes within weeks or even days, well before the patients have lost a significant amount of body weight.

Currently, bariatric surgery is only available as a treatment for severe obesity, defined as a body mass index of 35 kg/m2 or more, according to National Institutes of Health guidelines established in 1991. The consensus statement acknowledged that the cutoff is arbitrary and not supported by scientific evidence. "With an emphasis on caution and patient safety, the statement boldly advances a revolutionary concept, the legitimacy of gastrointestinal surgery as a dedicated treatment for type 2 diabetes in carefully selected patients," explains Dr. Rubino.

Based on earlier studies and on clinical experience in other countries, Dr. Rubino and his colleagues have found that removing portions of the jejunum or duodenum ? the upper part of the small intestine right below the stomach ? leads to spontaneous improvement or even resolution of diabetes. The same holds true when the surgeon simply inserts a tube in that part of the intestine, allowing food to pass through without coming into contact with the area. These findings suggest that when food normally passes from the stomach into the upper end of the small bowel, it triggers a cascade of hormonal reactions that cause diabetes.

"Prevention will always be the best strategy to approach the global epidemic of diabetes," says Dr. Rubino. "But gastrointestinal surgery promises to be an important addition to the treatments available, and its study may also allow us to understand the disease mechanism in depth. We can only prevent what we truly understand."



Source

Body Mass Index BMI A statistical method of figuring out the degree of excess or insufficient weight based on one's height & weight. Though the controversial BMI does not actually measure the percentage of body fat, it is a useful tool to estimate a healthy body weight based on how tall a person is.

Morbid Obesity A condition in which the Body Mass Index is 40.0–49.9, which is roughly equal to 100 pounds or more over ideal body weight; a weight level that is life-threatening. A BMI greater than 50 is termed as "super obese." CLICK HERE TO OPEN THE JOURNEY BMI CALCULATOR!

Bariatrics The branch of medicine that deals with the causes, prevention, and treatment of obesity. The term bariatrics was created around 1965, from the Greek root baro ("weight," as in barometer), suffix -iatr ("treatment," as in pediatrics), and suffix -ic ("pertaining to"). Besides the pharmacotherapy of obesity, it is concerned with obesity surgery.

Obesity Obesity results from the excessive accumulation of fat that exceeds the body's skeletal and physical standards. Obesity has been defined as a weight more than 20% above what is considered normal according to standard age, height, and weight tables, or by a complex formula known as the body mass index. According to the National Institutes of Health (NIH), an increase in 20 percent or more above your ideal body weight is the point at which excess weight becomes a health risk. CLICK HERE TO OPEN THE JOURNEY BMI CALCULATOR!

Diabetes Mellitus A disease that occurs when the body is not able to use blood glucose (sugar). Blood sugar levels are controlled by insulin, a hormone in the body that helps move glucose from the blood to muscles and other tissues. Diabetes occurs when the pancreas does not make enough insulin or the body does not respond to the insulin that is made. There are two main types of diabetes mellitus: Type 1 Diabetes and Type 2 Diabetes. All forms of diabetes have been treatable since insulin became medically available in 1921, but there is no cure.

Duodenum The first 12 inches of small intestine immediately below the stomach. Bile and pancreatic fluids flow into the duodenum from the liver and pancreas. Ducts from the pancreas and gallbladder bring in bicarbonate to neutralize stomach acid, pancreatic enzymes to further digestion, and bile salts to break up fats. Nutrient absorption begins in the lower duodenum.

Jejunum The middle part of the small intestine responsible for digestion. It's approximately ten feet in length and is between the duodenum and the ileum.

Metabolism All of the processes that occur in the body that turn the food you eat into energy your body can use. Exercise, food, and environmental temperature influence metabolism.

Type 2 Diabetes Previously known as "noninsulin-dependent diabetes mellitus" or "adult-onset diabetes" -- Type 2 diabetes is the most common form of diabetes mellitus. About 90 to 95 percent of people who have diabetes have type 2 diabetes. People with type 2 diabetes produce insulin, but either do not make enough insulin or their bodies do not efficiently use the insulin they make. Most of the people who have this type of diabetes are overweight. Therefore, people with type 2 diabetes may be able to control their condition by losing weight through diet and exercise. They may also need to inject insulin or take medicine along with continuing to follow a healthy program of diet and exercise. Although type 2 diabetes commonly occurs in adults, an increasing number of children and adolescents who are overweight are also developing type 2 diabetes.