Obesity operation may cure diabetes in many
A new study gives the strongest evidence yet that obesity surgery can cure diabetes.
Patients who had surgery to reduce the size of their stomachs were five times more likely to see their diabetes disappear over the next two years than were patients who had standard diabetes care, according to Australian researchers.
Most of the surgery patients were able to stop taking diabetes drugs and achieve normal blood tests.
ÏItÌs the best therapy for diabetes that we have today, and itÌs very low risk,Ó said the studyÌs lead author, Dr. John Dixon of Monash University Medical School in Melbourne, Australia.
The patients had stomach band surgery, a procedure more common in Australia than in the United States, where gastric bypass surgery, or stomach stapling, predominates.
Gastric bypass is even more effective against diabetes, achieving remission in a matter of days or a month, said Dr. David Cummings, who wrote an accompanying editorial in the journal but was not involved in the study.
ÏWe have traditionally considered diabetes to be a chronic, progressive disease,Ó said Cummings of the University of Washington in Seattle. ÏBut these operations really do represent a realistic hope for curing most patients.Ó
Diabetes experts who read the study said surgery should be considered for some obese patients, but more research is needed to see how long results last and which patients benefit most. Surgery risks should be weighed against diabetes drug side effects and the long-term risks of diabetes itself, they said.
The diabetes benefits of weight-loss surgery were known, but the Australian study in WednesdayÌs Journal of the American Medical Association is the first of its kind to compare diabetes in patients randomly assigned to surgery or standard care. Scientists consider randomized studies to yield the highest-quality evidence.
The study involved 55 patients, so experts will be looking for results of larger experiments under way.
'New way of thinking about diabetes'
ÏFew studies really qualify as being a landmark study. This one is,Ó said Dr. Philip Schauer, who was not involved in the Australian research but leads a Cleveland Clinic study that is recruiting 150 obese people with diabetes to compare two types of surgery and standard medical care.
ÏThis opens an entirely new way of thinking about diabetes.Ó

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Jan. 22, 2008
By Carla K. Johnson
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