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Gastric bypass urged for very obese diabetics


Gastric bypass urged for very obese diabetics -- Posted by Gumbo on 11-09-04 17:55


Gastric bypass urged for very obese diabetics
Oct 23 (Reuters Health) - Stomach bypass surgery should become 'standard
treatment' for morbidly obese patients with type 2 diabetes, researchers
recommend, because the majority achieve excellent glucose control following
the procedure.


In the Annals of Surgery, Dr. Philip R. Schauer, at the University of
Pittsburgh, and others describe the outcomes of 191 such patients who
underwent "keyhole" surgery to bypass a large part of the stomach. The
procedure drastically reduces the absorption of food.


Within days after surgery, about one third of the patients no longer
required anti-diabetes medication.


Among the 119 subjects who had diabetes for 5 years or less, the disease
completely resolved in 95 percent, with no recurrences during an average 20
months of follow-up.


For the entire group, average weight decreased from 308 to 211 pounds. Prior
to surgery, 65 percent required oral anti-diabetes medication and 27 percent
required insulin. Afterward, those figures dropped to 13 percent and 6
percent.


Also, many patients reported that diabetes-related nerve damage or erectile
dysfunction had improved.


The surgery is not without risks. Some 13 percent of patients experienced
problems, consisting primarily of pneumonia, small bowel obstruction or
blood clots. There was one death within the first month after surgery.


Nonetheless, Schauer's group says, "Unequivocally, surgery is superior to
medical management of type 2 diabetes" in very obese patients.


They recommend that gastric bypass in this situation should be performed
early in the course of the disease before permanent damage has occurred.


SOURCE: Annals of Surgery, October 2003.




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