Re:cured diabetes

[Guest guest]

Hold on there, folks, remember we are talking TYPE 2 diabetes! no

surgery, to date, will cure the childhood onset type 1 diabetes. Type 2

has a very high correlation with obesity, and given the recent stuff I

have heard, it is mostly a insulin resistance issue, rather than an

insulin deficiency issue. Weight loss alone can " cure " type 2 in many

cases-- but not all-- and there is still a lot they don't know about the

whole constellation of diabetic conditions! I think that calling the DS

or RNY the " cure " for type 2 diabetes is a bit premature. It is the

weight loss that improves the condition, from what I understand.

Nan E., diabetic, type 2, and not a medical professional.

________________________________________________________________

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[Guest guest]

I think that calling the DS

or RNY the " cure " for type 2 diabetes is a bit premature. >>>>>

Better take that up with the Hess report......he claims it DOES cure type 2!

Judie

Re:cured diabetes

> Hold on there, folks, remember we are talking TYPE 2 diabetes! no

> surgery, to date, will cure the childhood onset type 1 diabetes. Type 2

> has a very high correlation with obesity, and given the recent stuff I

> have heard, it is mostly a insulin resistance issue, rather than an

> insulin deficiency issue. Weight loss alone can " cure " type 2 in many

> cases-- but not all-- and there is still a lot they don't know about the

> whole constellation of diabetic conditions! I think that calling the DS

> or RNY the " cure " for type 2 diabetes is a bit premature. It is the

> weight loss that improves the condition, from what I understand.

> Nan E., diabetic, type 2, and not a medical professional.

> ________________________________________________________________

> GET INTERNET ACCESS FROM JUNO!

> Juno offers FREE or PREMIUM Internet access for less!

> Join Juno today! For your FREE software, visit:

> http://dl.www.juno.com/get/tagj.

>

> ----------------------------------------------------------------------

>

[Guest guest]

What seems true is that the surgery does indeed bring about a " cure "

for type II diabetes. And sometimes this is before any weight is

lost. It may not depend on which version of WLS is done either.

in Seattle

When I had my consult with Dr Gagner I asked him about this, and he said it's

because after surgery the patient is following the perfect diabetic diet.

Sheryl

[Guest guest]

What seems true is that the surgery does indeed bring about a " cure "

for type II diabetes. And sometimes this is before any weight is

lost. It may not depend on which version of WLS is done either.

in Seattle

When I had my consult with Dr Gagner I asked him about this, and he said it's

because after surgery the patient is following the perfect diabetic diet.

Sheryl

[Guest guest]

> I think that calling the DS

> or RNY the " cure " for type 2 diabetes is a bit premature. >>>>>

>

> Better take that up with the Hess report......he claims it

> DOES cure type 2!

Here are some abstracts (SEE BELOW) of studies that suggest that gastric

bypass causes a physiological change that plays a role in the remission

of type II diabetes post-operatively, and that " No other therapy has

produced such durable and complete control of diabetes mellitus " .

M.

---

in Valrico, FL, age 39

Starting weight 299, now 156

Starting BMI 49.7, now 26.0

Lap DGB/DS by Dr. Rabkin 10-19-99

http://www.duodenalswitch.com

Direct replies: mailto:melanie@...

#1:

----------------

World J Surg 2001 Apr;25(4):527-31 Related Articles, Books, LinkOut

Etiology of type II diabetes mellitus: role of the foregut.

Pories WJ, Albrecht RJ.

Department of Surgery, East Carolina University School of Medicine,

Greenville, North Carolina 27858, USA.

The Greenville version of the gastric bypass induced long-term remission

of type II diabetes mellitus in 121 of 146 (82.9%) morbidly obese

patients. Similarly, the operation returned 150 of 152 (98.7%) morbidly

obese patients with impaired glucose tolerance to euglycemia. These

outcomes were not merely changes in glucose levels; the operation also

reduced the mortality and morbidity of the disease. Diabetic patients

submitted to surgery had a 1.0% chance of dying during a 10-year period

of follow-up compared to a mortality rate of 4.5% in a matched group (p

= 0.0003). These results, the best therapeutic outcomes for type II

diabetes ever reported, suggest that the disease is not an untreatable,

hopeless illness but one that can be treated successfully with better

understanding of the pathophysiology of these surgical remissions. The

mechanism of the improvement is not yet clear. The rapidity of the

correction to euglycemia, usually a matter of days, suggests that the

reason is not the loss of weight (i.e., reduction in fat mass) but,

rather, the result of the exclusion of food and a secondary alteration

in incretin signals from the antrum, duodenum, and proximal jejunum to

the islets.

PMID: 11344408 [PubMed - indexed for MEDLINE]

#2:

----------------

Ann Surg 1998 May;227(5):637-43; discussion 643-4 Related Articles,

Books, LinkOut

A new paradigm for type 2 diabetes mellitus: could it be a disease of

the foregut?

Hickey MS, Pories WJ, Mac KG Jr, Cory KA, Dohm GL, Swanson MS,

Israel RG, Barakat HA, Considine RV, Caro JF, Houmard JA.

Department of Exercise and Sport Science, Colorado State University, Ft.

, USA.

SUMMARY BACKGROUND DATA: We previously reported, in a study of 608

patients, that the gastric bypass operation (GB) controls type 2

diabetes mellitus in the morbidly obese patient more effectively than

any medical therapy. Further, we showed for the first time that it was

possible to reduce the mortality from diabetes; GB reduced the chance of

dying from 4.5% per year to 1% per year. This control of diabetes has

been ascribed to the weight loss induced by the operation. These

studies, in weight-stable women, were designed to determine whether

weight loss was really the important factor. METHODS: Fasting plasma

insulin, fasting plasma glucose, minimal model-derived insulin

sensitivity and leptin levels were measured in carefully matched

cohorts: six women who had undergone GB and had been stable at their

lowered weight 24 to 30 months after surgery versus a control group of

six women who did not undergo surgery and were similarly weight-stable.

The two groups were matched in age, percentage of fat, body mass index,

waist circumference, and aerobic capacity. RESULTS: Even though the two

groups of patients were closely matched in weight, age, percentage of

fat, and even aerobic capacity, and with both groups maintaining stable

weights, the surgical group demonstrated significantly lower levels of

serum leptin, fasting plasma insulin, and fasting plasma glucose

compared to the control group. Similarly, minimal model-derived insulin

sensitivity was significantly higher in the surgical group. Finally,

self-reported food intake was significantly lower in the surgical group.

CONCLUSIONS: Weight loss is not the reason why GB controls diabetes

mellitus. Instead, bypassing the foregut and reducing food intake

produce the profound long-term alterations in glucose metabolism and

insulin action. These findings suggest that our current paradigms of

type 2 diabetes mellitus deserve review. The critical lesion may lie in

abnormal signals from the gut.

PMID: 9605655 [PubMed - indexed for MEDLINE]

#3:

--------------------

Ann Surg 1995 Sep;222(3):339-50; discussion 350-2 Related Articles,

Books, LinkOut

Who would have thought it? An operation proves to be the most effective

therapy for adult-onset diabetes mellitus.

Pories WJ, Swanson MS, Mac KG, Long SB, PG, Brown BM,

Barakat HA, deRamon RA, Israel G, Dolezal JM, et al.

Department of Surgery, School of Medicine, East Carolina University,

Greenville, North Carolina, USA.

OBJECTIVE: This report documents that the gastric bypass operation

provides long-term control for obesity and diabetes. SUMMARY BACKGROUND

DATA: Obesity and diabetes, both notoriously resistant to medical

therapy, continue to be two of our most common and serious diseases.

METHODS: Over the last 14 years, 608 morbidly obese patients underwent

gastric bypass, an operation that restricts caloric intake by (1)

reducing the functional stomach to approximately 30 mL, (2) delaying

gastric emptying with a c. 0.8 to 1.0 cm gastric outlet, and (3)

excluding foregut with a 40 to 60 cm Roux-en-Y gastrojejunostomy. Even

though many of the patients were seriously ill, the operation was

performed with a perioperative mortality and complication rate of 1.5%

and 8.5%, respectively. Seventeen of the 608 patients (< 3%) were lost

to follow-up. RESULTS: Gastric bypass provides durable weight control.

Weights fell from a preoperative mean of 304.4 lb (range, 198 to 615 lb)

to 192.2 lb (range, 104 to 466) by 1 year and were maintained at 205.4

lb (range, 107 to 512 lb) at 5 years, 206.5 lb (130 to 388 lb) at 10

years, and 204.7 lb (158 to 270 lb) at 14 years. The operation provides

long-term control of non-insulin-dependent diabetes mellitus (NIDDM). In

those patients with adequate follow-up, 121 of 146 patients (82.9%) with

NIDDM and 150 of 152 patients (98.7%) with glucose impairment maintained

normal levels of plasma glucose, glycosylated hemoglobin, and insulin.

These antidiabetic effects appear to be due primarily to a reduction in

caloric intake, suggesting that insulin resistance is a secondary

protective effect rather than the initial lesion. In addition to the

control of weight and NIDDM, gastric bypass also corrected or alleviated

a number of other comorbidities of obesity, including hypertension,

sleep apnea, cardiopulmonary failure, arthritis, and infertility.

Gastric bypass is now established as an effective and safe therapy for

morbid obesity and its associated morbidities. No other therapy has

produced such durable and complete control of diabetes mellitus.

Publication Types:

Clinical trial

PMID: 7677463 [PubMed - indexed for MEDLINE]

_________________________________________________________

[Guest guest]

Why there is a remarkable change in the way insulin is used in the

body post intenstinal rearrangements is still being researched. I

read numerous abstracts last spring trying to answer the " how "

and " why " questions for myself. There are theories out there. At

least that was all when I was looking for the info.. there may be

more out there now. Will remind myself to do another medline search

soon.

What seems true is that the surgery does indeed bring about a " cure "

for type II diabetes. And sometimes this is before any weight is

lost. It may not depend on which version of WLS is done either.

in Seattle

> I think that calling the DS

> or RNY the " cure " for type 2 diabetes is a bit premature. >>>>>

>

> Better take that up with the Hess report......he claims it DOES

cure type 2!

>

> Judie

[Guest guest]

Re:cured diabetes

> insulin deficiency issue. Weight loss alone can " cure " type 2 in many

> cases-- but not all-- and there is still a lot they don't know about the

> whole constellation of diabetic conditions! I think that calling the DS

I've read that it also depends on how long you've been diabetic. If you've

recently developed Type 2 diabetes, weight loss alone should resolve the

condition. For people who have had Type 2 for a prolonged period of time,

weight loss helps, but doesn't resolve the condition. I'm not a medical

professional, either...this is just what I've read.

alyssa

[Guest guest]

Re:cured diabetes

> insulin deficiency issue. Weight loss alone can " cure " type 2 in many

> cases-- but not all-- and there is still a lot they don't know about the

> whole constellation of diabetic conditions! I think that calling the DS

I've read that it also depends on how long you've been diabetic. If you've

recently developed Type 2 diabetes, weight loss alone should resolve the

condition. For people who have had Type 2 for a prolonged period of time,

weight loss helps, but doesn't resolve the condition. I'm not a medical

professional, either...this is just what I've read.

alyssa

[Guest guest]

depends on how long you've been diabetic. If you've

recently developed Type 2 diabetes, weight loss alone should resolve the

condition. For people who have had Type 2 for a prolonged period of time,

weight loss helps, but doesn't resolve the condition.>>>>>

I know of two people...one who had type 2 for 17 yrs and the other for 18

yrs......both completely in remission now! If it depends on how long you

had diabetes, how do you explain that?

Judie

[Guest guest]

depends on how long you've been diabetic. If you've

recently developed Type 2 diabetes, weight loss alone should resolve the

condition. For people who have had Type 2 for a prolonged period of time,

weight loss helps, but doesn't resolve the condition.>>>>>

I know of two people...one who had type 2 for 17 yrs and the other for 18

yrs......both completely in remission now! If it depends on how long you

had diabetes, how do you explain that?

Judie

[Guest guest]

Judie,

Oops .... Dr. Welker's email was just sent back to me as undeliverable ...

got any other e-mail address for him ??

Bye,

Donna

[Guest guest]

Judie,

Oops .... Dr. Welker's email was just sent back to me as undeliverable ...

got any other e-mail address for him ??

Bye,

Donna

[Guest guest]

instead of using the link type it in......

kjwelker@...

its the only one I have and worked for me just a couple days ago.

Judie

Re: Re:cured diabetes

> Judie,

>

> Oops .... Dr. Welker's email was just sent back to me as undeliverable ...

> got any other e-mail address for him ??

>

> Bye,

> Donna

>

>

>

>

> ----------------------------------------------------------------------

>

[Guest guest]

instead of using the link type it in......

kjwelker@...

its the only one I have and worked for me just a couple days ago.

Judie

Re: Re:cured diabetes

> Judie,

>

> Oops .... Dr. Welker's email was just sent back to me as undeliverable ...

> got any other e-mail address for him ??

>

> Bye,

> Donna

>

>

>

>

> ----------------------------------------------------------------------

>

[Guest guest]

Thank you, Judie! " in remission " was the phrase I was trying to

think of. I don't think WLS is a " cure " for diabetes. For Type 2

diabetics, the symptoms and the problems go away when they

lose the excess weight. Sometimes even earlier...I think it has to

do with the change in diet after surgery? The disease goes into

remission, not away. If they were to gain the weight back, I think

the odds are that the symptoms and problems would come

back. This is unlikely after DS surgery, so essentially it is

considered a " cure. " Unfortunately, long-term diabetics can also

suffer from vision loss, kidney problems and loss of sensation

and circulation in the extremities. I haven't found anything about

DS having an effect on those symptoms once they've started.

Sadly, this doesn't apply to Type 1 diabetics. From what I know,

most of them aren't overweight to begin with.

Take care,

> I know of two people...one who had type 2 for 17 yrs and the

other for 18

> yrs......both completely in remission now! If it depends on how

long you

> had diabetes, how do you explain that?

>

> Judie

[Guest guest]

Thank you, Judie! " in remission " was the phrase I was trying to

think of. I don't think WLS is a " cure " for diabetes. For Type 2

diabetics, the symptoms and the problems go away when they

lose the excess weight. Sometimes even earlier...I think it has to

do with the change in diet after surgery? The disease goes into

remission, not away. If they were to gain the weight back, I think

the odds are that the symptoms and problems would come

back. This is unlikely after DS surgery, so essentially it is

considered a " cure. " Unfortunately, long-term diabetics can also

suffer from vision loss, kidney problems and loss of sensation

and circulation in the extremities. I haven't found anything about

DS having an effect on those symptoms once they've started.

Sadly, this doesn't apply to Type 1 diabetics. From what I know,

most of them aren't overweight to begin with.

Take care,

> I know of two people...one who had type 2 for 17 yrs and the

other for 18

> yrs......both completely in remission now! If it depends on how

long you

> had diabetes, how do you explain that?

>

> Judie

[Guest guest]

You might find it interesting to look at the results of the DCCT

trial. The DCCT is a clinical study conducted from 1983 to 1993 by

the National Institute of Diabetes and Digestive and Kidney Diseases

(NIDDK). The study showed that keeping blood sugar levels as close to

normal as possible slows the onset and progression of eye, kidney,

and nerve diseases caused by diabetes. In fact, it demonstrated that

any sustained lowering of blood sugar helps, even if the person has a

history of poor control.

http://www.niddk.nih.gov/health/diabetes/pubs/dcct1/dcct.htm#study

IT is easy to suggest that the change in intake causes the change in

glucose levels. However, this does not seem to be the total

explanation for the phenomenen.

Disbetes is diagosed by symptoms, not by pathophysiological changes.

The absence of the symptoms then would mean the lack of critera to

diagnose the problem.

in Seattle

> Thank you, Judie! " in remission " was the phrase I was trying to

> think of. I don't think WLS is a " cure " for diabetes