Type 2 diabetes treatment: Surgical procedures and new drugs


Some diabetes patients think there is nothing new for treating type 2 diabetes. Actually, a lot is totally new, including surgical procedures and innovative drugs.

This explanation is a little longer than some, precisely because so much is totally new in diabetes treatment and care. Scientific study has a greater understanding of the interplay between hormones and blood sugar control, and this insight has given rise to new procedures. Increasing awareness of the importance of patient responsibility has prompted new models for behavior modification. New diabetes drugs not just don't put weight you, they actually help you lose it, and surgery is being viewed by some like a cure.

Gastric bypass surgery involves sectioning off a little pouch in the upper the main stomach and attaching it towards the lower part of the small intestine, leaving merely a small area of the stomach to hold food. This method was once recommended only for dangerously obese people facing severe health threats, but today it is being performed on more than 140,000 overweight people in the United States each year, a large number of whom have type 2 diabetes.

And it is revealing startling results - glucose levels go back to normal even before any weight reduction. When asked in an April 2008 An hour interview whether he considered gastric bypass surgery a cure for diabetes, Dr. Neil Hutcher, a gastrointestinal surgeon in Richmond, Virginia, that has performed more than 3,000 bypass surgeries, replied, "I think my patients are cured. They go home on no medication, and I've followed them now for ten and fifteen years and find out no proof of recurrence."

he CBS report said studies confirm that about 80 percent of people with type 2 diabetes who've had gastric bypass surgery get into complete remission within days of their operation. Dr. David Cummings, appetite expert and professor of medicine in the University of Washington, confirmed the remission rate at 84 percent, saying, "A third of patients walk out from the hospital three days after their surgery completely off their diabetes medications, and most from the others shed their diabetes medications within a couple weeks."

In 2003 Dr. Philip Schauer, MD, director from the Bariatric Metabolic Institute in the Cleveland Clinic in Cleveland, Ohio, and president of the American Society for Bariatric Surgery (ASBS), was one of the first to exhibit that after bariatric surgery, patients' blood sugars returned to normalcy before any significant weight loss.

"Part of this is explained in what bariatric surgery gives the gastrointestinal tract," said Dr. Schauer. "We now know that there is an alteration of the gut (gastrointestinal) hormones which affect both insulin production and utilization." Scientists are discovering that clear on these gut hormones, called incretins, affect glycemic control far more dramatically than once was thought.

Dr. Francesco Rubino, a pioneering authority in gastrointestinal metabolic surgery and chief of gastrointestinal metabolic surgery at New York Presbyterian/Weill Cornell, is advancing "diabetes surgery" as an entirely new field, one in which gastrointestinal operations can be performed to directly treat diabetes, not only obesity. Dr. Rubino's "diabetes surgery" has been performed on obese patients at several centers worldwide, and clinical trials have started on diabetes patients who are not obese.

Laparoscopic gastric banding is yet another surgical treatment that helps promote weight loss and, as a result, may free patients from medication. During gastric banding an adjustable band is positioned round the upper part of the stomach, sectioning off merely a small pouch to hold food. With this procedure the resolution of diabetes goes hand in hand using the resolution of bodyweight, says Dr. David Cummings.

Banding does not "cure" diabetes along with gastric bypass, which affects the hormones responsible for blood sugar levels metabolism. Yet banding was reported to become a more effective treatment for diabetes compared to best current medical care with existing medicines, diet, and use.

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