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Medical Forum / Diseases and Disorders / Diabetes / April 2008Anybody watch "60 Minutes" tonight?
There was a lot of new information about CURING diabetes with gastric bypass surgery. I found it very interesting. They seem to believe that type 2 diabetes originates in the duodenum and that a hormone named Ghrelin has lots to do with it. Bypass seems to immediately cure diabetes, and I don't like to use the term "cure" but they used it freely on tonights show. Also they claim that mortality rates for gastric bypass are lots lower than for gall bladder surgery, at the present time, which I also found amazing. A couple of years ago they were not so good. Maybe it is time to look into it again. I did look into it a couple of years ago and decided against it at that time.  SignatureBest Regards, Evelyn > There was a lot of new information about CURING diabetes with gastric > bypass surgery. I found it very interesting. They seem to believe [quoted text clipped - 9 lines] > Maybe it is time to look into it again. I did look into it a couple of > years ago and decided against it at that time. Evelyn, it's not true, and most folks gain the weight back, probably because their hunger is driven by their endocrine status, not the size of their stomachs. Type 2 diabetes comes from many things, not just one hormone in the duodenem or from insulin resistance (I am very sensitive to insulin), or from obesity. It's very likely that those who are DM prior to the surgery are the ones most likely to regain. Or those with undiagnosed hypercortisolemia, which causes steroid driven hunger. Susan > x-no-archive: yes > [quoted text clipped - 21 lines] > are the ones most likely to regain. Or those with undiagnosed > hypercortisolemia, which causes steroid driven hunger. Personally I see type 2 as a symptom. I think there is far more than one disease we are suffering from, yet we all get lumped together. I just see too many variations. Susan Wrote: > Evelyn, it's not true, and most folks gain the weight back, probably > because their hunger is driven by their endocrine status, not the size > of their stomachs. I don't think the Brazilian study cited is consistent with the wide body of data on this topic. Most folk lose lots of weight even 5 years out. Here's one: // ******************************************************************************************* Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Christou NV, Sampalis JS, Liberman M, Look D, Auger S, McLean AP, MacLean LD .Ann Surg. 2004 Sep;240(3):416-23; discussion 423-4. Section of Bariatric Surgery, Division of General Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada. nicolas.christou@MUHC.McGill.ca OBJECTIVE: This study tested the hypothesis that weight-reduction (bariatric) surgery reduces long-term mortality in morbidly obese patients. BACKGROUND: Obesity is a significant cause of morbidity and mortality. The impact of surgically induced, long-term weight loss on this mortality is unknown. METHODS: We used an observational 2-cohort study. The treatment cohort (n = 1035) included patients having undergone bariatric surgery at the McGill University Health Centre between 1986 and 2002. The control group (n = 5746) included age- and gender-matched severely obese patients who had not undergone weight- reduction surgery identified from the Quebec provincial health insurance database. Subjects with medical conditions (other then morbid obesity) at cohort-inception into the study were excluded. The cohorts were followed for a maximum of 5 years from inception. RESULTS: The cohorts were well matched for age, gender, and duration of follow-up. Bariatric surgery resulted in significant reduction in mean percent excess weight loss (67.1%, P < 0.001). Bariatric surgery patients had significant risk reductions for developing cardiovascular, cancer, endocrine, infectious, psychiatric, and mental disorders compared with controls, with the exception of hematologic (no difference) and digestive diseases (increased rates in the bariatric cohort). The mortality rate in the bariatric surgery cohort was 0.68% compared with 6.17% in controls (relative risk 0.11, 95% confidence interval 0.04-0.27), which translates to a reduction in the relative risk of death by 89%. CONCLUSIONS: This study shows that weight-loss surgery significantly decreases overall mortality as well as the development of new health-related conditions in morbidly obese patients. // ******************************************************************************************* To underscore the point: http://www.springerlink.com/content/012pl1161010n53x/ Daniéla Oliveira Magro1, 2 , Bruno Geloneze3, Regis Delfini2, Bruna Contini Pareja2, Francisco Callejas2, 4 and José Carlos Pareja2, 4 (1) Preventive Medicine Department, University of Campinas (UNICAMP), Campinas, Brazil (2) Obesity Surgery Center of Campinas, Campinas, Brazil (3) Internal Medicine Department, Division of Endocrinology, University of Campinas (UNICAMP), Campinas, Brazil (4) Surgery Department, University of Campinas, UNICAMP, Campinas, Brazil Received: 26 March 2007 Accepted: 8 May 2007 Published online: 8 April 2008 Abstract Background A certain weight gain occurs after obesity surgery compared to the lower weight usually observed between 18 and 24 months postsurgery. The objective of this study was to evaluate weight regain in patients submitted to gastric bypass over a 5-year follow-up period. Materials and Methods A longitudinal prospective study was conducted on 782 obese patients of both genders. Only patients with at least 2 years of surgery were included. The percentage of excess body mass index (BMI) loss at 24, 36, 48, and 60 months postsurgery was compared to the measurements obtained at 18 months after surgery. Surgical therapeutic failure was also evaluated. Results Percent excess BMI loss was significant up to 18 months postsurgery (p < 0.001), with a mean difference in BMI of 1.06 kg/m2 compared to 12 months postsurgery. Percent BMI loss was no longer significant after 24 months, and weight regain became significant within 48 months after surgery (p < 0.01). Among the patients who presented weight regain, a mean 8% increase was observed within 60 months compared to the lowest weight obtained at 18 months after surgery. The percentage of surgical failure was higher in the superobese group at all times studied, reaching 18.8% at 48 months after surgery. Conclusion Weight regain was observed within 24 months after surgery in approximately 50% of patients. Both weight regain and surgical failure were higher in the superobese group. Studies in regard to metabolic and hormonal mechanisms underlying weight regain might elucidate the causes of this finding. Keywords Morbid obesity - Gastric bypass - Gastroplasty - Weight regain This is a fascinating look not only at results after WLS, but at the role of starches, insulin levels, etc. play in driving hunger. http://www.obesityonline.org/meetings/unique_approaches/aronne/aronne.pdf Susan Hi Susan, Thanks for this. I will look further. I have several friends who had the surgery several years ago, and none of them have regained the weight. Also none of them have needed to go back on diabetes meds or insulin again. I don't know if I just happen to have atypical friends, or if the results you have quoted are perhaps not accurate or recent? Hard to know.... It puts me in a bit of a quandary when my friends and this particular news cast seem to say something different from the results I have heard and read myself before, and which you have provided here again. How can one know what is the actual truth? SignatureBest Regards, Evelyn > x-no-archive: yes > [quoted text clipped - 48 lines] > > Susan > Hi Susan, > [quoted text clipped - 7 lines] > results you have quoted are perhaps not accurate or recent? Hard to > know.... Well, yeah, they are recent. For public examples, Al Roker, Carney Wilson, Randy Jackson... > It puts me in a bit of a quandary when my friends and this particular > news cast seem to say something different from the results I have heard > and read myself before, and which you have provided here again. How > can one know what is the actual truth? By reading the studies of larger groups than the ones you and I have cited above. :-) Susan > There was a lot of new information about CURING diabetes with gastric bypass > surgery. We, who are practicing physicians, are also seeing this with the use of the 2PD-OMER Approach, albeit without the high mortality rate associated with gastric bypass surgery. > I found it very interesting. They seem to believe that type 2 > diabetes originates in the duodenum and that a hormone named Ghrelin has > lots to do with it. Ghrelin is a beneficial hormone that does increase hunger (health): http://groups.google.com/group/sci.med.cardiology/msg/5c7df4006f6205f0? The problem is that the delusion that hunger is bad causes the irrational compulsion to overeat resulting in the formation of black fat (VAT) that in turn causes type-2 diabetes: http://HeartMDPhD.com/BlackFat > Bypass seems to immediately cure diabetes, and I don't > like to use the term "cure" but they used it freely on tonights show. Forcing people to eat less has this effect. It is no different from people choosing to eat less of their own free will. > Also they claim that mortality rates for gastric bypass are lots lower than > for gall bladder surgery, at the present time, which I also found amazing. This is not true. The current best figures seen for rates of **major** complications for gastric bypass surgery is 8.7% which is much higher than for elective laparoscopic gall bladded surgery. Source: J Gastrointest Surg. 2007 April; 11(4): 500–507. Link to PDF of full-text of this article: http://EmoryCardiology.com/GastricBypass.pdf > A couple of years ago they were not so good. Still not. > Maybe it is time to look into it again. I did look into it a couple of > years ago and decided against it at that time. Much smarter to simply eat less, down to the right amount: http://HeartMDPhD.com/BeSmart A simple parable given in hopes of promoting greater understanding: http://HeartMDPhD.com/Parable Be hungry... be healthy... be hungrier... be euglycemic: http://TheWellnessFoundation.com/BeHealthier Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow How DARE you reply to me! Screw off Chung. I am NEVER addressing you when I post. SignatureBest Regards, Evelyn convicted neighbor Evelyn Ruut wrote: > There was a lot of new information about CURING diabetes with gastric > bypass > surgery. We, who are practicing physicians, are also seeing this with the use of the 2PD-OMER Approach, albeit without the high mortality rate associated with gastric bypass surgery. > I found it very interesting. They seem to believe that type 2 > diabetes originates in the duodenum and that a hormone named Ghrelin has > lots to do with it. Ghrelin is a beneficial hormone that does increase hunger (health): http://groups.google.com/group/sci.med.cardiology/msg/5c7df4006f6205f0? The problem is that the delusion that hunger is bad causes the irrational compulsion to overeat resulting in the formation of black fat (VAT) that in turn causes type-2 diabetes: http://HeartMDPhD.com/BlackFat > Bypass seems to immediately cure diabetes, and I don't > like to use the term "cure" but they used it freely on tonights show. Forcing people to eat less has this effect. It is no different from people choosing to eat less of their own free will. > Also they claim that mortality rates for gastric bypass are lots lower > than > for gall bladder surgery, at the present time, which I also found amazing. This is not true. The current best figures seen for rates of **major** complications for gastric bypass surgery is 8.7% which is much higher than for elective laparoscopic gall bladded surgery. Source: J Gastrointest Surg. 2007 April; 11(4): 500–507. Link to PDF of full-text of this article: http://EmoryCardiology.com/GastricBypass.pdf > A couple of years ago they were not so good. Still not. > Maybe it is time to look into it again. I did look into it a couple of > years ago and decided against it at that time. Much smarter to simply eat less, down to the right amount: http://HeartMDPhD.com/BeSmart A simple parable given in hopes of promoting greater understanding: http://HeartMDPhD.com/Parable Be hungry... be healthy... be hungrier... be euglycemic: http://TheWellnessFoundation.com/BeHealthier Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow > Andrew, in the Holy Spirit, boldly wrote: > > [quoted text clipped - 62 lines] > > How DARE you reply to me! The boldness comes from GOD. Laus Deo ! ! ! http://HeartMDPhD.com/LausDeo > Screw off Chung. Your reaction simply shows that the Holy Spirit is absolutely right to convict you: http://HeartMDPhD.com/Convicts You really don't have much longer, dear Evelyn: http://HeartMDPhD.com/HolySpirit/Prophecy May you wisely choose to repent soon by publicly declaring with your mouth that "Jesus is LORD:" http://HeartMDPhD.com/HolySpirit/TheWay Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow > Maybe it is time to look into it again. I did look into it a couple of > years ago and decided against it at that time. Only if they can give you half a dozen peer review articles to support their statements. > There was a lot of new information about CURING diabetes with gastric > bypass surgery. I found it very interesting. They seem to believe that [quoted text clipped - 9 lines] > Maybe it is time to look into it again. I did look into it a couple of > years ago and decided against it at that time. That won't help those of us who are not overweight enough to warrant the surgery. I bought a book on ghrelin some years ago. It was recommended to me by someone from the psoriasis newsgroup, but now I can't remember the reason he recommended it to me. Alas, I couldn't understand it. It was over my head. I need Quentin to read it for me and translate in cute language I can understand. Ha! >> There was a lot of new information about CURING diabetes with gastric >> bypass surgery. I found it very interesting. They seem to believe [quoted text clipped - 18 lines] > head. I need Quentin to read it for me and translate in cute language I > can understand. Ha! Julie that was another part of the segment..... they are doing a form of bypass now on people who are not overweight, just in order to stop the diabetes. For the overweight ones they are making the stomach smaller of course, but there is something about bypassing the duodenum that stops the diabetes. SignatureBest Regards, Evelyn > Julie that was another part of the segment..... they are doing a form of > bypass now on people who are not overweight, just in order to stop the > diabetes. For the overweight ones they are making the stomach smaller > of course, but there is something about bypassing the duodenum that > stops the diabetes. It also causes nutritional deficiencies. Susan As a person who has lost 100+ pounds without surgery, I found the report interesting, but a bit sad, especially the woman who was talking about cheesecake but then saying she couldn't even eat it if she wanted to. Taking away that power of choice, to me, is sad and doesn't follow the way we were created to live. Even though I've chosen not to eat cheesecake for four years (and I don't crave it, either, even though it used to be one of my favorites) I think I would resent it if my power of choice was taken away. On the other hand, when it gets to the regaining the weight part, I think there are, as Mark Twain put it, "statistics, damned statistics and lies." I bet each person has their own story and I know that, in some cases at least, the "body finds a way" to put the weight back on. It's hard to know if you'll be a success story or not if you have the surgery. And, the way I look at it, any surgery is risky. I'm glad I found my way without it. Donna www.ICanStopOvereating.com > As a person who has lost 100+ pounds without surgery, I found the > report interesting, but a bit sad, especially the woman who was [quoted text clipped - 19 lines] > > Donnawww.ICanStopOvereating.com You don;t want to lose your power of choice? We all lost our power of choice on here. Our "power of choice" is to choose to do all we can to not get complications. That's about it. On Apr 21, 8:35 am, Donna Kozik <donnatel...@yahoo.com> wrote: > As a person who has lost 100+ pounds without surgery, I found the > report interesting, but a bit sad, especially the woman who was [quoted text clipped - 19 lines] > > Donnawww.ICanStopOvereating.com You don;t want to lose your power of choice? We all lost our power of choice on here. Our "power of choice" is to choose to do all we can to not get complications. That's about it. It's still a choice though. Many people choose to ignore their diabetes, consequences be damned. Unfortunately we seldom get to pick the situations for which we must make choices. SignatureBest regards, Michelle C., T2 diet & exercise BMI 21.5 > As a person who has lost 100+ pounds without surgery, I found the > report interesting, but a bit sad, especially the woman who was [quoted text clipped - 20 lines] > Donna > www.ICanStopOvereating.com Donna you are to be commended for your committment and willpower, but all one needs to do is look around us to see that not everyone is equally gifted in those qualities. SignatureBest Regards, Evelyn >There was a lot of new information about CURING diabetes with gastric bypass >surgery. I found it very interesting. They seem to believe that type 2 >diabetes originates in the duodenum and that a hormone named Ghrelin has >lots to do with it. Bypass seems to immediately cure diabetes, and I don't >like to use the term "cure" but they used it freely on tonights show. It does seem to "cure" people whose primary diabetic issue is a large stomach - one where the normal physical action of food hitting the back of the stomach and starting off the gut hormone reactions to eating can't happen because the food gets lost in the stomach sac. Do I recall you're on Byetta, Evelyn? - that does the same kind of job without the surgery risk, and if you're able to lose weight on it, it also shrinks your stomach AND possibly increases your beta cell mass at the same time. Nicky. T2 dx 05/04 + underactive thyroid D&E, 100ug thyroxine Last A1c 5.6% BMI 25 >>There was a lot of new information about CURING diabetes with gastric >>bypass [quoted text clipped - 18 lines] > D&E, 100ug thyroxine > Last A1c 5.6% BMI 25 Hi Nicky, Yes, I am still on the Byetta and like it. SignatureBest Regards, Evelyn >There was a lot of new information about CURING diabetes with gastric bypass >surgery. I found it very interesting. They seem to believe that type 2 [quoted text clipped - 8 lines] >Maybe it is time to look into it again. I did look into it a couple of >years ago and decided against it at that time. Gys posted a lot of stuff about this a while back (to the point that Ted started abusing him as a scammer) Oh look, he just joined in below. My impression: it certainly affects *something* but I'd be more inclined to wait for further research into what the "something" is and whether it can be targetted with drugs or dietary factors rather than the knife. Also as there are several gazillion similar but different diseases under the heading of Type 2, it may well be a crapshoot as to whether it would work for any specific individual. Do a LOT of research before going for this IMNSHO |
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