Did Doctors Discover a Cure for Type 2 Diabetes?

Weight-loss surgery has typically been used for one thing alone: to achieve weight-loss, duh. But a new study in today's New England Journal of Medicine has found that, surprisingly, it also works to put patients with type 2 diabetes into remission. That seems crazy, since for so long the only way to manage or reverse diabetes was considered to be by carefully restricting your diet, but this discovery appears to change the way we look at treating the increasingly common disease.

The study looked at patients with severe type 2 diabetes and randomly assigned them one of three treatments: gastric bypass surgery; bilopancreatic diversion surgery (BPD), where part of the stomach is removed; and conventional medication and specific changes to diet and lifestyle. What they found was that 95 percent of those who had the BPD surgery went into full remission, which they maintained for the two-year period of the study. Of those who had gastric bypass, 75 percent of them went into remission. Of the patients who stayed with the traditional medicine/diet treatment, none of them went into remission. Kind of hard to argue with those numbers.

While it might seem that losing the weight from surgery is the reason the diabetes improves, that's actually not the case. The study found the results were independent of the weight loss patients achieved. Dr. Francesco Rubino, director of the Diabetes Surgery Center at New York-Presbyterian Hospital/Weill Cornell Medical Center, led the study and explains that while they don't fully understand the process of how the surgery affects the diabetes, it has to do with the changes made to the organs:

We found that the change in the anatomy of the stomach and intestines can improve diabetes directly. The stomach and intestine are not just there for absorption of nutrience. They also serve as an endocrine organ and make dozens of hormones. Those hormones are directly relevant to the regulation of the body's insulin.

That's fascinating, as are these dramatic results, which Rubino says are "an unprecedented effect that we've never seen in diabetes before. Remission hasn't even been a word in the textbooks about diabetes." So does this mean anyone with diabetes should rush to their doctor's office begging for surgery? Not quite yet. Rubino says for the time being non-obese patients shouldn't get the surgery. While that might be the protocol in a few years, for now only obese patients with diabetes should be considered for the procedure. Obviously this is invasive, life-altering surgery, so it's not exactly some quick fix. And it would be preferable to find a non-surgical way to keep people from getting the disease in the first place. But if these initial results hold up over time, then this certainly does seem like it could be an excellent option for patients who've already got type 2 diabetes.

New study: Weight-loss surgery may cure diabetes [CBS]

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