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Weight-Loss Surgery for Obese People With Diabetes

Those who had gastric bypass dropped the most weight, some saw their type 2 diabetes disappear, studies found

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In the second study, a team led by Dr. Florencia Halperin of Brigham and Women's Hospital in Boston tracked the one-year outcomes of 38 obese or very obese people with type 2 diabetes. The patients underwent either gastric bypass or drug/lifestyle weight-management interventions.

Again, the surgery seemed to produce the best results, according to the study. Fifty-eight percent of people in the gastric bypass group saw their type 2 diabetes go into remission within a year after the procedure, compared to just 16 percent of those who got the lifestyle intervention.

People who got the surgery also saw improvements in weight, waist circumference, blood pressure and blood cholesterol levels, the Boston researchers said.

Both studies were funded in part by the U.S. National Institutes of Health.

Halperin's team stressed, however, that a much larger clinical trial is needed -- something that might be difficult to put together.

Kini agreed. He said there are "potential challenges to successfully completing a larger randomized, controlled trial for treatment of type 2 diabetes and obesity in obese patients." Both of the new studies had only a small number of people enrolled, Kini noted.

Dr. Mitchell Roslin is chief of bariatric surgery at Northern Westchester Hospital in Mount Kisco, N.Y. He said that "the data is clear -- the treatment of choice for type 2 diabetes and morbid [severe] obesity is a gastric bypass procedure."

Roslin believes that the time has come for insurance companies and other third-party payers to help cover the cost of these procedures for obese type 2 diabetics.

"Why, with data this clear, are only a minority of patients with diabetes and other metabolic diseases secondary to obesity having these lifesaving procedures?" he asked. "Until there are better medical remedies, obese type 2 diabetics should be treated with gastric bypass procedures."

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