Gastric Bypass surgery benefits

[Guest guest]

Thought the group would be interested in reading this:

Gastric bypass surgery resolves or improves diabetes in most

patients, reports Pittsburgh study

PITTSBURGH, Oct. 2 – A study of obese people with type 2 diabetes who

underwent laparoscopic gastric bypass surgery (LGBP) found that 83

percent of them experienced a resolution of their disease.

The study, from the University of Pittsburgh School of Medicine, is

in the October issue of the journal ls of Surgery.

The study also found that clinical resolution or improvement in

diabetes occurred in all patients, but patients with the shortest

duration and mildest form of type 2 diabetes had a higher rate of

resolution after the surgery. During the study there were no new

occurrences or recurrences of type 2 diabetes in 310 patient years of

follow-up. Nearly one third of patients permanently discontinued anti-

diabetic medications after discharge from the hospital – even before

significant weight loss could occur.

According to Philip Schauer, M.D., director of bariatric surgery at

the University of Pittsburgh, principal investigator in the study and

co-director of the Minimally Invasive Surgery Center at the

University of Pittsburgh Medical Center, the study suggests that

early surgical intervention is warranted to increase the likelihood

of rendering these patients euglycemic.

" Most patients in the study with type 2 diabetes who underwent bypass

surgery achieved excellent biochemical glycemic control and were able

to reap the clinical benefits of withdrawing from most, if not all,

anti-diabetes medications, including insulin, " Dr. Schauer

said. " Younger diabetes patients with less severe disease stand to

gain more from the surgery by circumventing years of progressive,

debilitating disease. "

The study included 1,160 patients who underwent Roux-en Y gastric

bypass surgery (LGBP) between 1997 and 2002 at the University of

Pittsburgh Medial Center. Of those patients, 240 had impaired fasting

glucose and type 2 diabetes. Follow-up was possible in 190. The mean

age at surgery was 48 years and 75 percent of the patients were

female. Mean body mass index was 50.

" Prior to surgery, the disease severity for these patients was quite

significant overall, " said Dr. Schauer, " with 65 percent of them

requiring oral agents and 27 percent of them requiring insulin as

well. "

Post surgery, patients had a mean excess weight loss of 60 percent

and a body mass index of 34 after 20 months. Fasting plasma glucose

and glycoslated hemoglobin concentrations returned to normal levels

in 83 percent of patients, while 17 percent of patients markedly

improved. Following surgery, 80 percent of patients had a significant

reduction in the use of oral anti-diabetic agents and 79 percent had

a reduction in their use of insulin.

" The impressive effect of bypass surgery on morbidly obese patients

with type 2 diabetes raises an argument for lowering the threshold

for surgical intervention to moderate or mild obesity, " Dr. Schauer

said. " Further investigation demonstrating risk versus benefit for

patients with moderate obesity is warranted. "

The LGBP procedure involves constructing a small stomach pouch of

approximately 15 millimeters (about the size of a plastic medicine

cup), and bypassing a small segment of intestines by constructing a Y-

shaped limb of small bowel. Patients lose weight because there is a

decrease in caloric intake resulting from the reduced reservoir

capacity of the small stomach pouch.

Type 2 diabetes is the most common form of diabetes, in which the

body is unable to properly use the insulin that it produces. About 80

percent of people with type 2 diabetes are overweight.

Rachael in Northern Virginia

proximal RNY 5-10-01

from 326 then to 188 now.