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Bariatric surgery may help send Type 2 diabetes into remission
by Laura Edington
Richmond County Daily Journal
Jan 22, 2013 | 4615 views | 0 0 comments | 5 5 recommendations | email to a friend | print
Raymond Washington
Raymond Washington
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New studies show that bariatric surgery may help put Type 2 diabetes into remission, reports FirstHealth of the Carolinas.

The Cleveland Clinic said that diabetes experts now believe that bariatric surgery “should be offered much earlier as a reasonable treatment option for patients with poorly controlled diabetes — and not as a last resort.”

According to the American Diabetes Association, Type 2 diabetes is the most common type of diabetes. It is caused by the body not producing enough insulin or the cells in the body ignoring the insulin.

The Centers for Disease Control said that 25.8 million people were affected with diabetes in 2011.

In October 2012, the Cleveland Clinic released the Top 10 Medical Innovations for 2013 which shows that bariatric surgery can help control diabetes when medicine cannot.

“Bariatric surgery shrinks the stomach into a small pouch and rearranges the digestive tract so that food enters the small intestine at a later point than usual,” the Cleveland Clinic said.

The Clinic said that many surgeons performing the weight-loss surgery see the procedure “rid patients of Type 2 diabetes, often times before the patient leaves the hospital.”

Weight-loss surgeons at Moore Regional Hospital have observed this remission phenomenon multiple times in their patients with Type 2 diabetes. In the 43 bariatric procedures performed at Moore Regional between August 2011 and November 2012, 13 patients had Type 2 diabetes. According to recent clinic records, 12 are now off all of their diabetes medications.

“Bariatric surgery can have a profound effect on diabetes, and many published studies have looked at the effect,” said bariatric surgeon Raymond Washington. “Surgery can account for almost an 80 percent remission of diabetes. Oftentimes, patients with non-insulin-dependent diabetes will leave the hospital off of their oral medications after only a few days,” he said.

Washington and another surgeon, David Grantham, are the only FirstHealth bariatric surgeons according to Emily Sloan, assistant director of public relations at FirstHealth of the Carolinas.

All patients, in Richmond County, wanting or needing bariatric surgery have the procedure done by either Washington or Grantham.

While it isn’t known exactly why bariatric surgery can cause Type 2 diabetes to go into remission, two American Diabetes Association-sponsored researchers may have an answer.

In his research, Christopher Newgard, Ph.D. of North Carolina’s Duke University Medical Institute and the Sara W. Stedman Nutrition and Metabolism Center, found a link between increased circulating concentrations of certain kinds of amino acids and insulin resistance. Insulin is the hormone that delivers sugar to cells to give them energy and in diabetes, the body does not use insulin properly.

Blandine Laferrere, M.D., of St. Luke’s Roosevelt Institute for Health Sciences in New York, observed that patients undergoing bariatric surgery have greatly reduced levels of these amino acids, indicating that the changes are somehow involved in post-surgical diabetes remission.

“Removing the lateral aspect of the stomach induces hormonal and metabolic changes that have a profound effect on insulin and blood glucose,” Dr. Washington said. “This occurs before any significant weight loss and is notable in both gastric bypass and sleeve gastrectomy.”

According to published reports, Dr. Newgard and Dr. Laferrere plan to focus on the effect of amino acids in diabetes in their future research and are hopeful that their preliminary findings could even lead to advancements in diabetes treatments.

Rick Sousa, of Raeford, is one patient with Type 2 diabetes who benefited from bariatric surgery. Less than a month after his surgery at FirstHealth Moore Regional Hospital, the 45-year-old FirstHealth paramedic started to notice an encouraging change in his blood sugar levels.

“They were slowly going down,” he said.

Except for the two multivitamins he takes daily, Sousa no longer needs any kind of medication. He is completely off his oral diabetes medicine as well as the medication he took to lower his cholesterol and to prevent problems with his blood pressure and kidneys, said a statement released by FirstHealth of the Carolinas.

Sousa said, “I’m feeling fantastic.”

Diabetes remission is just one of several benefits that Sousa has experienced since his surgery. He said he was “always a big kid,” and at the time of his surgery, he had reached 330 pounds.

By December 2012, approximately four months after the operation, he was down to 237 pounds and wearing extra-large T-shirts instead of the quadruple X’s that had been once part of his wardrobe.

Sousa can also participate in activities that used to leave him tired and winded, like backpacking with his 13-year-old son’s Boy Scout troop.

“They don’t have to wait for me anymore,” Sousa said. “I’m usually in front of them. They have to catch up with me. Depending on how good I feel, I have to wait for them once in a while,” he said.

FirstHealth of the Carolinas offers two information sessions each month on its weight-loss surgery program. For more information, call 800-213-3284 or visit www.ncweightlosssurgery.org.

— Staff Writer Laura Edington can be reached at 910-997-3111, ext. 18, or by email at ledington@civitasmedia.com.



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