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Diabetes Surgery


Cure for Type 2 Diabetes Now a Reality

Arnold (not his real name) is a 56 year-old lawyer. Like most busy professionals he barely has time to go to the gym. He is morbidly obese and had diabetes for several years. He is worried that he may not make it into 60 to see his grandkids grow up. He wants what many doctors would say is impossible--he wants to be cured from diabetes.

According to the Centers for Disease Control and Prevention (CDC), diabetes is becoming more common in the United States. From 1980 through 2005, the number of Americans with diabetes increased from 5.6 million to 15.8 million. There’s an additional estimated 5 million undiagnosed cases. In that same period, the crude incidence of diagnosed diabetes increased by 124%.  The complications of this disease are putting a heavy burden on U.S. health costs. Recently, during an annual meeting of the American Association of Clinical Endocrinologists in Seattle, it was reported that Americans are spending $57.1 billion a year as direct medical expenses for Type 2 Diabetes and its complications.

To complicate matters, obesity has also become an epidemic. In a recent report by the CDC, more than one-third of U.S. adults -– over 72 million people -- were obese in 2005-2006. Because obesity and diabetes often go hand in hand, a new term has been coined to describe America’s current healthcare crisis: ‘the diabesity epidemic”.
There are many factors influencing obesity and diabetes rates. Sedentary lifestyles, ubiquitous junk food, the supersizing of meal portions and “emotional eating” are just a few.  Various approaches to treat obesity have been widely advertised in the media. However, dietary and pharmaceutical methods of weight loss are currently fairly ineffective, especially in the morbidly obese. In the meantime, we have always thought that diabetes is a chronic and relentless disease, where the only possible treatment goal is just the control of hyperglycemia and minimization of the risk of complications.
Weight Loss Surgery or Bariatric Surgery has been done since the 1950s and was proven to be the most effective method in attaining a durable and clinically significant weight loss and more importantly resolving co-morbidities like Type 2 Diabetes and more than 30 other health problems related to obesity. Type 2 Diabetes resolved in 76.8% of patients and significantly improved in 86% who underwent bariatric surgery.
Based on these results, there is growing evidence that surgery, specifically Gastro-intestinal Bypass, may effectively cure Type 2 Diabetes even in patients who are not morbidly obese.  
Arnold went to see one of the PMTI surgeons, a regular member of the American Society for Metabolic and Bariatric Surgery, fellow of the American College of Surgeons and president of the Philippine Society for Metabolic and Bariatric Surgery.  He says that the upper small intestine may be the point of interest in diabetes and bypassing this segment would solve the problem of sugar metabolism. “This surgery is usually done laparoscopically, utilizing very small incisions in the abdomen. When performed on diabetic subjects, the nutrient’s passage is diverted from the upper intestines and diabetes resolves. The exact pathophysiology of the upper intestine in diabetic patients causing hyperglycemia remains to be seen. The theory is that gastrointestinal hormones produced in response to the transit of nutrients are not balanced in diabetic subjects. The exclusion of the upper small intestine from the transit of nutrients may offset the hormonal imbalance thereby resulting in remission of diabetes.”
Arnold underwent Laparoscopic Roux-en-Y Gastric Bypass last 2007 and seven days after surgery he never needed any medical treatment for diabetes. Today he is 40 lbs lighter and free from diabetes.  Indeed, the future seems to be getting sweeter for the life of a diabetic patient.