Studies: Surgery for weight loss may help against diabetes

CHICAGO - New research provides clear evidence that the surgeries performed to help patients lose weight can reverse and possibly cure diabetes. Doctors say he should be offered as an initial option for those with the disease, not only as a last resort.

Two studies released on Monday compared to stomach reduction surgery with medication in obese people with type II diabetes. Millions of people have this disease and can not produce enough insulin or effectively harness they produce.

The studies found that the surgery helped many more patients to achieve normal levels of blood glucose than drugs.

The results were dramatic: some people may stop taking insulin even three days after their operations. The levels of cholesterol and other risk factors also improved greatly.

The doctors do not like to say "cure" because they can not promise that a disease will not return, but in one study, most patients undergoing surgery were able to stop taking any medication for diabetes and have the disease in remission for at least two years. No one who was treated only with drugs had the same progress.

"It's a breakthrough," said Dr. John Buse of the University of North Carolina at Chapel Hill, a prominent diabetes expert who was not connected with the studies.

Buse said he often recommends surgery for obese patients who can not control their glucose levels with medication, but many are wary. "This evidence will help convince them that this is indeed an important therapy that is worth considering," he said.

The studies were published online by the New England Journal of Medicine and one was presented Monday at a conference of the American College of Cardiology in Chicago.

For a century doctors have treated diabetes with pills and insulin and more recently have urged their patients lose weight and exercise, but with little success. Very few obese people can lose enough kilos without surgery and many of the medicines used to treat diabetes can cause weight gain, which makes things worse.

Surgery offers hope for a long term solution. Gastric bypass surgery is the most common. With it, doctors reduce his stomach to the size of a bag and reconnect to the intestine.

A previous study evaluated the gastric band, a less drastic and reversible to limit the size of the stomach. This technique reduced blood glucose, but these patients had mild diabetes. The new studies evaluated the permanent surgery for weight loss in people with severe and longstanding diabetes.