60 Minutes, April 20 - Diabetes Cure?

[awriter]

Last night's 60 Minutes piece on gastric bypass surgery was an eye-opener. Turns out one of the unexpected side effects is that type 2 diabetes in severely obese patients is *instantly* reversed (as in, 4 or so days after surgery) - BEFORE any weight loss occurs. One day a patient is obese and diabetic, the next the patient is still obese but not diabetic. And that reversal now appears to be permanent - that is, a cure.

This has struck so many doctors as odd that one doctor in Brazil decided to experiment on diabetic mice. He performed a bypass and diabetes disappeared. Then, to *prove* cause and effect, he reversed the procedure. Diabetes instantly reappeared.

Researchers say that it seems that bypassing the duodendum is the key here, but my question is - why? What is it about food going through the stomach (or not) that is changing insulin sensitivity and BS differences in such a major way? What is the biological mechanism in operation here?

Currently this surgery is only available to the morbidly obese as a last resort, which is understandable despite the mortality risk statistics major improvement due to new, less invasive techniques. But wouldn't it be wonderful if diabetes researchers find a way to isolate the mechanism and somehow duplicate the results without the surgery? :)

Lisa

[pennink]

I saw that too. I kept wanting to raise my hand that all my problems, like theirs, were gone, too!

I wish both things were shown to work. There's a high rate of morbidity with with the gps. Glad I did it on my own and learned what to eat and not to!

[awriter]

I saw that too. I kept wanting to raise my hand that all my problems, like theirs, were gone, too!

It's great that over time many diabetics are able to get rid of the symptoms of diabetes, and sometimes even the disease itself - but surely you're not suggesting that if they can isolate *why* the bypass instantly cures diabetes that would be a bad thing?

There's a high rate of morbidity with with the gps.

Well, that was the other interesting thing I learned from the piece last night: though there *was* a high rate of morbidity, there no longer is. The risk of complication has gone from 1 in 100, to 1 in 1000 - same as gaul bladder surgery. That's due to the new, less invasive (laproscopic) techniques. And of course, given the obesity problems these patients have for *any* surgery, this is pretty good.

I agree that learning healthy living and eating habits is always a good thing generally, but the scientist geek in me now wants to know WHY this works, and what that answer could mean for all of us.

Lisa

[pennink]

I would just hate to see a surgery prescribed when low carb works efficiently. Ask any of the diabetics (I was borderline T2) and it, and my CHF, is completely gone.

Not sure if the reporting of the morbidity rates are right. There was a lot of hoopla here about people dying from it just last year. My doctor and I discussed it at length.

Yes, it's interesting to find out why it happens. I just know it's not the only way. Avoiding carbs would work to prevent the disease in the first place, too.

[LessLiz]

There is a surgical procedure that is being researched in which the stomach is left intact but the duodenum is removed. Those people have the same result in terms of Type II diabetes. The experiment was done on 6 people, and I recall reading that it is being done in some countries other than the US.

I would caution that the duodenum is the only place where many substances are absorbed. You can almost guarantee pernicious anemia will result.

[Nancy LC]

Though the duodenum is such a tiny fraction of the small intestine, it is the site of most of the breakdown of the food passing through it. The duodenum is lined with Brunner's glands, which secrete an alkaline mucus that supports the intestinal enzymes and aids in the absorption of nutrients. The pancreatic duct, which introduces bile and pancreatic juice into the small intestine, is directly connected to the descending duodenum. Pancreatic juice contains enzymes that help break down food, while bile aids in the digestion and absorption of fats. The duodenum is responsible for secreting hormones that trigger the pancreatic duct to release pancreatic juice and bile.
So... if it is removed, how malnourished do you get from being unable to break down your food?

It seems to me they should be exploring WHY the duodenum is a factor in diabetes, not just settling for removing it. Maybe being malnourished is the cure?

[awriter]

Maybe being malnourished is the cure?

Doubtful, since many third world countries have plenty of malnourishment AND diabetes. But something else you quoted caught my eye:

"The duodenum is responsible for secreting hormones..."

I'm not a scientist (and don't even play one on TV), but anything involved with hormones seems like a good place to start to look.

As for anemia potential after bypass - yes, that's a well-documented side effect, and all patients are told they'll need supplements the rest of their lives.

Note to Pennick: I'm NOT advocating surgery in any way, so I'm not sure why you keep mentioning it in your replies to my posts. I AM saying that I hope research will show what the biological mechanism is behind the instant reversal, which might help in discovering an instant cure - or even preventative - some day. While I believe that eating low carb is as good a preventative as we have now, it's unrealistic to think that an entire population (pressured, as they are, to eat an anti-preventative diet by the medical establishment) will switch to it anytime soon. I'm truly glad you were able to reverse your disease. Many are not for a wide variety of reasons, so any research that might help them is surely to be hoped for.

Lisa

[RobLL]

I, like most of you, will follow this closely. In say five years they are discovering that the side affects of the surgery are significantly less than the side affects of even well controlled diabetes I would seriously considering getting the surgery. My thinking on this is that I will follow the scientific emperical results of whatever treatment increases health.

[Nancy LC]

I doubt you could get the surgery unless you're extremely overweight. That was one thing they mentioned in the show was the guidelines for the surgery you had to be obese to morbidly obese so you couldn't get it just to cure T2 diabetes.

[awriter]

I doubt you could get the surgery unless you're extremely overweight.
Nancy,

If mortality risk continues to decrease significantly for this surgery - and IF they cannot find what about that surgery is causing the instantaneous remission (and somehow duplicate it without the surgery), I have no doubt that the current guidelines/weight for surgery will be changed downward. Or people will simply go out of country, as they already do (and I did) for cutting edge medicine that isn't available here yet.

When I thought about going to Belgium to have my hip resurfaced because I refused to have perfectly good bone amputated in the typical hip replacement here, the FDA had not approved the procedure. Despite the nearly 20 years of huge success with the new procedure (called hip-resurfacing) overseas, they insisted on calling it 'experimental.'

By the time they approved it (May, two years ago) I desperately needed the surgery but no U.S. physician had any experience - so off to Belgium I went. And fought my insurance company's denial to pay when I returned - and won. :) Best decision I ever made in my life. I would not hesitate to ignore U.S. guidelines again if my own research determined that better medical procedures were available elsewhere. If bypass turns out to be, not only an instant cure for diabetes, but the only instant cure available a few years hence, I'm sure many others will feel the way I did about my hip.

Lisa

[RobLL]

I have read that the average cost to the medical care system is $35,000 a year. I am inclined to doubt that figure, but dialysis, amputation care, hospitalizations, ulcers on legs, blindness, infections, etc are all terribly expensive. The surgery is said to cost $25,000. Hmmmmm

[awriter]

I have read that the average cost to the medical care system is $35,000 a year. I am inclined to doubt that figure, but dialysis, amputation care, hospitalizations, ulcers on legs, blindness, infections, etc are all terribly expensive. The surgery is said to cost $25,000.

And overseas? Far, far less. The tab for my operation came to $15,000. And that included: pre-surgery tests (x-rays, blood work, even a visit at the Villa from a Cardiologist - and he came to see me), surgery, doctor's fee, 2-night hospital stay, AND one week's rehab that included a daily hour of individual rehab plus two more in the pool in a specially designed Villa - three fabulous meals a day, whipped cream and Belgium chocolates included. :) That's right: $15,000.

And the same surgery in the 4-star Apollo hospital in Chennai, India where everyone who comes when you ring the bell is a registered nurse, and which puts our hospitals to shame? $7,500.

Same hip resurfacing surgery in the U.S. now, with NO rehab (let alone a week in a Villa): $40k-$50k.

Oh - and where did I first learn about resurfacing three years ago? A piece on 60 Minutes. :D

Makes you think, doesn't it?

Lisa

[Nancy LC]

Lisa, you're right. I didn't even think about going overseas. My sister's friend took her husband to China for a stem-cell treatment for his Parkinson's he couldn't get here. Sad... we used to be #1 here.

Isn't the whole justification for keeping medicine free-enterprise and capitalistic that it is supposed to spur improvements? It seems like the places with socialized medicine are further along than we are in many respects.

[CarolynC]

Jenny/lottadata has written an interesting response to the 60 Minutes piece on gastric bypass surgery in her blog. See:

http://diabetesupdate.blogspot.com/2008/04/gastric-bypass-cures-and-kills.html

[awriter]

Jenny/lottadata has written an interesting response to the 60 Minutes piece on gastric bypass surgery in her blog.

Interesting, mostly incorrect, and cherry-picked as to the study she quotes. For instance, she writes:

-- "Yesterday night the TV news show, 60 Minutes, ran a segment promoting the idea that gastric bypass surgery can cure diabetes."

60 Minutes didn't "promote" anything. They simply stated the facts: For unknown reasons, bypass surgery instantly cures Diabetes II.

-- "Not content with promoting this dangerous surgery to the morbidly obese, surgeons are now recommending it for people who are merely overweight."

In NO way did anyone on that segment advocate surgery for people who are "merely overweight." The doctors involved, like me, are intensely curious to find out what *about* the surgery is creating the instant cure of a chronic disease.

--"Something like 1 in 200 people who have gastric bypass surgery die within six weeks of the surgery."

As stated in the segment: while that used to be the case (back in 1999-2004, which is when the study she quotes was done), it is NO LONGER TRUE due to improved, less invasive techniques.

-- "But what is far more significant is that many more people who have this surgery--including those who lose a lot of weight--die within five years of the surgery."

Aside from the study being no longer relevant as to deaths immediately following surgery, the study's conclusion about the *cause* of these deaths states that they are not, in fact, due to the surgery itself.

Conclusion states: "There was a substantial excess of deaths owing to suicide and coronary heart disease."

Hello? Suicide and CHD - NOT the surgery. Of course the stats for long term mortality for this population is going to be worse than their match of "gender and age" in the general population. To have a valid study, they would have had to match bypass patients to non-bypass patients who were not only as obese, but who had the same rates of CHD, diabetes, etc. By the time many of these patients have the surgery, their bodies are already seriously compromised in terms of short and long-term health.

Note to Study organizers and Blog writer: Comparing Apples and Oranges isn't helpful to science. Opinionators, on the other hand, love them.

Also in the Conclusion: "...careful monitoring of bariatric surgical procedures and more intense follow-up could likely reduce the long-term case fatality rate in this patient population."

Indeed - and that's just what has happened since: big changes in surgical procedures and more intense follow-up. Thus, we now see the changing-for-the-better statistics since that study was done.

Is there risk with this surgery? Yes. There's risk with all surgery. For *some* patients the risk of non-surgery is higher, and so they have it, hoping it will help. IMHO, scare articles and blogs based on a careless reading of a poorly designed study don't help anyone. YMMV.

But of course, that wasn't the point of the 60 Minutes segment or this thread. In those cases the point was to look at the instant remission of diabetes (without any weight loss) caused by this surgery and to begin to ask why, so that perhaps a cure can be found that doesn't include any surgery at all.

Lisa

[Korban]

I agree Lisa,

The results as they relate to T2's are both remarkable and provocative. One should hope that it opens up the possibility for new avenues of research in the field of diabetes.

Regarding the use of the surgery for weight loss: I have absolutely little knowledge of bariatric surgery, no particular opinion on, and really very little interest in, one way or the other.

Of course YMMV,
/smile

[Nancy LC]

A 13% mortality rate 9 years after GB? Holy cow, I'd rather take my chances with the diabetes.

[RobLL]

awriter - the golden standard for any major surgery or medications is death rate over the long term. We do not understand the unintended consequences of intervention well enough to discount TOTAL death rate in ensueing years. And my sister, intelligent, but unread on the subject did in fact call me and understand the report as a cure for diabetes and a recommendation for the surgery.

[Korban]

The following might be of interest: according to this study one's odds would marginally improve with the surgery rather than with "severe" obesity anyway... it says nothing about quality of life.

http://www.thinnertimes.com/gastricbypass/gastric_bypass_outcomes.html

Effects of bariatric surgery on mortality in Swedish obese subjects.
N Engl J Med. 2007 Aug 23;357(8):741-52.

Sjöström L, et. al

BACKGROUND: "Obesity is associated with increased mortality. Weight loss improves cardiovascular risk factors, but no prospective interventional studies have reported whether weight loss decreases overall mortality..."

"...Subjects study involved 4047 obese subjects. Of these subjects, 2010 underwent bariatric surgery (surgery group) and 2037 received conventional treatment (matched control group)..."

"...There were 129 deaths in the control group and 101 deaths in the surgery group..."

"...CONCLUSIONS: Bariatric surgery for severe obesity is associated with long-term weight loss and decreased overall mortality." Copyright 2007 Massachusetts Medical Society

[awriter]

A 13% mortality rate 9 years after GB?

First, the numbers are irrelevant because they are old statistics based on surgical procedures no longer done.

Second, the numbers are irrelevant because without a control group of severely obese people who didn't have surgery to measure against, those numbers tell us nothing. For instance, if 26% of severely obese patients who *didn't* have the surgery died over the same 9 years - that 13% would suddenly not only look good, it would look like a good chance at living to year ten by comparison.

I rest my case with the study/numbers Korban just provided: with an up to date statistic, measuring apples against apples, bypass surgery for a certain population seems like a pretty good deal.

Finally, I repeat, and will continue to repeat, that this thread is NOT about having or not having bypass surgery, and NOT about whether bypass surgery is a good or bad thing, and NOT about the merits of remaining virtuously diabetic by not having the surgery or even about ridding oneself of diabetes by years of virtuous low carbing.

It IS about the fact that with the surgery, diabetes is instantly cured, and if and when researchers find out WHY this is so, it may be possible to find an instant cure that does NOT involve surgery. I began this thread excited by the possibility of a new place for researchers to concentrate, and remain just as excited by the hope that a cure for this disease may rise from this unexpected discovery.

Lisa

[RobLL]

........It IS about the fact that with the surgery, diabetes is instantly cured, and if and when researchers find out WHY this is so, it may be possible to find an instant cure that does NOT involve surgery. I began this thread excited by the possibility of a new place for researchers to concentrate, and remain just as excited by the hope that a cure for this disease may rise from this unexpected discovery.....

Lisa

Heartily concur

[Lottadata]

Lisa,

CHD is also what is written on the death certificates of many people who die of anorexia. Malnutrition leads to electrolyte imbalances which lead to heart attacks.

And when they find 16 suicides and 14 drug overdoses (mostly in people with no history of drug overdoses) in a population where the demographic would predict 2, there is something going on that needs investigation.

I never said that everyone who has this surgery will develop fatal complications or kill themselves. What I'm saying is that there is a lot of evidence that the actual death rate from gasric surgery is MUCH higher than surgeons inform patients. That's because they only cite the 30 day death rate, not the long-term death rate.

The study of deaths after all weight loss surgeries in Pennsylvania cited in my blog should be a wake up call to anyone who thinks this is a safe procedure.

And as others have pointed out, you can get the same "cure" for your diabetes by cutting way back on your carbs.

But the same health authorities and media that promote irreversible surgeries still tell people "we can't recommend low carb diets because they might be dangerous."

But hey, if you want to amputate part of your gut, feel free.

[awriter]

What I'm saying is that there is a lot of evidence that the actual death rate from gasric surgery is MUCH higher than surgeons inform patients.

There may or may not be actual, relevant, *scientific* evidence. There may or may not be a "lot" of it. Unfortunately, neither on your blog nor in this forum have you provided any.

And so I would like to gently remind you that this thread is NOT about having or not having bypass surgery, and NOT about whether bypass surgery is a good or bad thing, and NOT about the merits of remaining virtuously diabetic by not having the surgery or even about ridding oneself of diabetes by years of virtuous low carbing.

If you wish to start a thread about the pros and cons of bypass surgery, by all means do so - I'm sure it will be interesting. But THIS thread is about the fact that with the surgery, diabetes is instantly cured, and if and when researchers find out WHY this is so, it may be possible to find an instant cure that does NOT involve surgery. I began this thread excited by the possibility of a new place for researchers to concentrate, and remain just as excited by the hope that a cure for this disease may rise from this unexpected discovery.

[Nancy LC]

Second, the numbers are irrelevant because without a control group of severely obese people who didn't have surgery to measure against, those numbers tell us nothing. For instance, if 26% of severely obese patients who *didn't* have the surgery died over the same 9 years - that 13% would suddenly not only look good, it would look like a good chance at living to year ten by comparison.Well, you'll always get to reuse that same argument because you need the passage of time in order to assess the long term risk. I'm sure 10 years from now that they'll be onto a totally different procedure and then you can dismiss the people who died after their GB in 2008.

A control group isn't hard to find. Pick an equal number of people with similar stats and see how many of them die. I seem to recall that the article Jenny quoted did just that. The 13% mortality rate was far, far greater.

Junkfood Science's author then looked at death rates for people with the same demographic who did not have surgery and reports "The U.S. National Center for Health Statistics of the Centers for Disease Control and Prevention data reports that the overall death rates among Americans of the same age is 0.352% — for men it is 0.44% while for women this age it’s 0.26%."

So basically people who had weight loss surgery were dying at a rate many times higher than normal--even the rate normal for obese people.

As far as to whether or not the 60-minutes piece was balanced or not? Did it present the risks, like the long-term death rate and complications? Did it talk about how many people regain their weight afterwards? If it left that sort of stuff out, or gave it short shrift then it was hardly balanced. It'd be like covering the war in Iraq up to the taking of Baghdad and saying "and they lived happily ever after", without mentioning that 5 years later things are really, really bad. You can skew the news simply by failing to report on the bad stuff.

[Korban]

It sure was interesting how diabetes was suddenly cured with the procedure...

Re: morbidly obese patients/control groups/surgery - I could have quoted another study (link was on the same page as the last one), with control groups, but that was with surgeries dating back over 20 years which I suspect is ancient history now. Interestingly though, it still showed greater survival among those that had the surgery. As to quality of life...? I suspect one would have to ask the participants - did you like being morbidly obese better than the alternative? (Unfortunately, I doubt that many of the morbidly obese patients were offered the option of the Banting or other low carbohydrate diets...).

It seems to me as though there are strong feelings on this issue for whatever reason, perhaps due to the earlier history and 30-day incidence of morbidity in much of the earlier work. Perhaps this bias is due to bad science, old techniques, or prejudicial science. That bad science exists should not surprise any of us on this forum.

I suspect that the state of the art regarding most surgical and diagnostic procedures has come a long way in the past 20 or 30 years. Is bariatric surgery still as risky and bad today as implied above, I mean even as bad as coconut oil? :) I don't know, nor am I morbidly obese, thank god.

Isn't it interesting though how diabetes was immediately alleviated? This might suggest that a solution or mediation of the disease may be down a path that researchers have heretofore not studied. Maybe a realistic and reasonable solution has now become just a bit more obvious to someone. I hope so.

Have a nice day,
/smile

[awriter]

Whether or not the 60-minutes piece was balanced or not?

Nancy,

I'm sure that would be an interesting conversation to have, and if you start a thread about it I will be happy to participate and give you my opinions, which are indeed different than your own.

However, whether or not the 60 Minutes segment was balanced, unbalanced or even done on Mars is irrelevant to *this* thread, since THIS thread is about the hopes that researchers can learn what biological mechanism *in* the surgery is instantly curing diabetes - and replicate that results for diabetics WITHOUT the surgery.

Now, you can keep on responding to this thread with irrelevant comments about your opinions of the *surgery* instead of this thread, and I can keep responding in precisely the same way as here, and in two other comments above, or we can both hopefully move on to other more constructive conversations. I would prefer the latter, but it's your call.

Lisa

[glennette]

My question is..what do they concider to be an instant "cure", anyone know?
To me, a cure would be that I could go back to eating anything I wanted while maintaining an A1c between 4-5%. Do they specify what the A1c levels of the patients were before and after surgery?

[Korban]

...To me, a cure would be that I could go back to eating anything I wanted while maintaining an A1c between 4-5%.

From what little I know regarding the matter (definitely more than I originally intended to know), a prescribed diet must be maintained since the stomach is now much smaller and only limited amounts of food or liquid can be taken in, usually not at the same time. The amount of intake can slowly be increased over time. Alternatively, you can eat all you want and vomit... or die, which, to me, doesn't sound too appetizing. For those that do not follow the recommended diet protocols, post surgery, the consequences can be dire, including death.

Carbohydrates are still restricted as they are more apt to swell and cause intestinal blockages... which John Ritter had... before he died.

On the plus side, you can get rid of that nasty finger pricker and don't have to take blood glucose checks... and eventually, assuming you follow the appropriate precautions, can commence to maintain some higher level of personal hygiene not available to the morbidly obese (for which the surgery is recommended).

Damn, this sounds depressing...

So yes, you can eat anything you want, but you can do that today as well regardless of whether you are T1, T2, or have bariatic surgery. It seems to me the question is, are you willing to accept the consequences.............:)

I think I will just stay with LC and exercise for the time being.

/smile

P.S> you are probably right, your A1c would be between 4 and 5% :)

[doegirl]

Hey, sounds like this thread needs to go into the War Zone!

[Nancy LC]

Nancy,

I'm sure that would be an interesting conversation to have, and if you start a thread about it I will be happy to participate and give you my opinions, which are indeed different than your own.

However, whether or not the 60 Minutes segment was balanced, unbalanced or even done on Mars is irrelevant to *this* thread, since THIS thread is about the hopes that researchers can learn what biological mechanism *in* the surgery is instantly curing diabetes - and replicate that results for diabetics WITHOUT the surgery.

Now, you can keep on responding to this thread with irrelevant comments about your opinions of the *surgery* instead of this thread, and I can keep responding in precisely the same way as here, and in two other comments above, or we can both hopefully move on to other more constructive conversations. I would prefer the latter, but it's your call.

Lisa

Here is why I comment on the surgery and the imbalances of the reporting that was done:

I, like most of you, will follow this closely. In say five years they are discovering that the side affects of the surgery are significantly less than the side affects of even well controlled diabetes I would seriously considering getting the surgery. My thinking on this is that I will follow the scientific emperical results of whatever treatment increases health.

Because people have seen this episode and they're not thinking "Oh, how interesting someday perhaps it will be discovered why this happens" they're thinking about getting the operation themselves. You even mentioned it yourself that you could go overseas and have it done.

If bypass turns out to be, not only an instant cure for diabetes, but the only instant cure available a few years hence, I'm sure many others will feel the way I did about my hip.

Clearly this thread is also about gastric bypass surgery. There isn't a whole lot to say about it curing diabetes other than remarking on how interesting it is and we hope to know why that is someday, because right now there really isn't much known about it. So if you don't want anyone to actually discuss the surgery and the possible issues with it, there just isn't a whole lot to talk about in this thread.

It might be this thread didn't go in the direction you intended but well, that's kind of the nature of these things.

[Lottadata]

A control group isn't hard to find. Pick an equal number of people with similar stats and see how many of them die. I seem to recall that the article Jenny quoted did just that. The 13% mortality rate was far, far greater.


Here's an interesting blog that cites some data establishing the true mortality for obesity.

Junkfood Science Blog: When Scares Become Deadly (http://junkfoodscience.blogspot.com/2007/02/when-scares-become-deadly-weighing.html)

[Korban]

Go Nancy...:) and thank god that Lotta has the "real" data. I h8 the fake stuff.

But war zone? - seems to me that controversy stimulates thought - and helps one get their ducks in a row... but war? I hope it is not taken personally. I mean, my god, life is tough enough without peers h8ing...:) I have rather enjoyed this thread, have learned a bit, and hardly think of it as war.

Okay, all those that are going to go get bariatric surgery, raise your hands...

/smile

[Korban]

Jenny,

Do you think the deaths from Bariactric surgery are due to difficulty of the technique or lack of compliance of the obese patients? I didn't get a feel for that from your link nor do I have any idea. They also distinguish obesity which is quite easily treatable (with /cough LC diets) and make one comment re: morbidly obese patients and it has nothing to do with bariatric surgery...

It seems to me that anyone that has bariatric surgery for obesity as I have now (BUT I AM ALMOST OVERWEIGHT !! ) is a sad testimony to the state of dietary recommendations... low fat, etc. The Swedish study I referenced in this thread dealt with survival of "severely obese" patients. Perhaps there is a baseline death rate from the surgery regardless of BMI - just guessing now.

/smile

[awriter]

Because people have seen this episode and they're not thinking "Oh, how interesting someday perhaps it will be discovered why this happens" they're thinking about getting the operation themselves.

While I appreciate your belief in your infallibility to somehow know what other people think or not, it doesn't change the fact that this thread is about the possibility of giving researchers a new way to look at this disease. That some people have attempted to hijack it to ride their own particular hobby horses is irrelevant to that reality.

Again, I remind you of what the thread is: a discussion about the hope that the 'instant cure' the surgery affords will someday help point the way to a non-surgical cure. And what it isn't: a discussion about the surgery itself. And I gently repeat my invitation to you to start such a thread if in fact you truly are interested in the topic. I'm sure others will be happy to debate the point with you. As I'm not one of them, I will simply continue to remind you of these facts rather than respond to your repeated attempts to engage me in your arguments. It's just kind of the nature of these things. :)

Have a great evening!

Lisa

[gwynne2]

I really don't think you can force people to only discuss a given topic in a way that you deem appropriate. Weight-loss surgery is at the heart of the topic, so people are naturally going to discuss different aspects of it. I'm sorry you're not getting the response you'd hoped for (and I don't have a dog in this fight, having little personal knowledge of diabetes or WLS), but I really don't think you're going to succeed in pushing (valid) tangents into another thread. It seems like it must be very frustrating to try.

[MamaMarie]

I, like most of you, will follow this closely. In say five years they are discovering that the side affects of the surgery are significantly less than the side affects of even well controlled diabetes I would seriously considering getting the surgery. My thinking on this is that I will follow the scientific emperical results of whatever treatment increases health.

I'm considering the surgery myself. (Never thought I'd say those words!)

When you see your grandma dying in her 60's from T2 diabetes complications and you see your dad's kidneys failing in his 40's, then you get diagnosed with diabetes... well, you start to think.

Gonna do *lots* of homework before I leap into *that* briar patch, though! :)

[MamaMarie]

I doubt you could get the surgery unless you're extremely overweight. That was one thing they mentioned in the show was the guidelines for the surgery you had to be obese to morbidly obese so you couldn't get it just to cure T2 diabetes.

I looked it up and here are the guidelines: BMI over 40 OR a BMI over 35 with a comorbidity (such as high BP or diabetes... something deadly associated with obesity).

I am 180 and "chubby". I am just 15 pounds from the BMI of 35. It doesn't take as much as people would think to qualify.

[MamaMarie]

Lisa, you're right. I didn't even think about going overseas. My sister's friend took her husband to China for a stem-cell treatment for his Parkinson's he couldn't get here. Sad... we used to be #1 here.

Isn't the whole justification for keeping medicine free-enterprise and capitalistic that it is supposed to spur improvements? It seems like the places with socialized medicine are further along than we are in many respects.

Don't get me started. My kid's a Type 1 diabetic and I just *burn* over the FDA's foot-dragging when it comes to new research.

[Lottadata]

My understanding is that the deaths from bariatric surgery come from:

1. Nonhealing wounds.

2. Destruction of the parts of the digestive system that absorb nutrients either from having too much removed, or destruction of tissue through infection and the multiple surgeries that people end up having when complications arise.

3. Mental problems with eating that develop thanks to the changes in gut hormones affecting the brain. Incretin hormones most definitely DO impact the brain. When I took Januvia I developed mild anorexia, which is so utterly NOT me that I knew it was drug related, but it made eating very tough. It was, fortunately, reversible when I stopped the drug.


Jenny,

Do you think the deaths from Bariactric surgery are due to difficulty of the technique or lack of compliance of the obese patients? I didn't get a feel for that from your link nor do I have any idea. They also distinguish obesity which is quite easily treatable (with /cough LC diets) and make one comment re: morbidly obese patients and it has nothing to do with bariatric surgery...

It seems to me that anyone that has bariatric surgery for obesity as I have now (BUT I AM ALMOST OVERWEIGHT !! ) is a sad testimony to the state of dietary recommendations... low fat, etc. The Swedish study I referenced in this thread dealt with survival of "severely obese" patients. Perhaps there is a baseline death rate from the surgery regardless of BMI - just guessing now.

/smile

[Korban]

My understanding is that the deaths from bariatric surgery come from:

1. Nonhealing wounds.

2. Destruction of the parts of the digestive system that absorb nutrients either from having too much removed, or destruction of tissue through infection and the multiple surgeries that people end up having when complications arise.

3. Mental problems with eating that develop thanks to the changes in gut hormones affecting the brain. Incretin hormones most definitely DO impact the brain. When I took Januvia I developed mild anorexia, which is so utterly NOT me that I knew it was drug related, but it made eating very tough. It was, fortunately, reversible when I stopped the drug.

I think I will just stick with what I am doing now. I especially don't need any more mental problems. :)

[awriter]

I really don't think you can force people to only discuss a given topic in a way that you deem appropriate.

That's absolutely true. But neither can those people force me into arguing their points of contention or becoming engaged in their opinions - and those posts were addressed to me personally. To every one of those posts I will simply and politely continue to repeat, ad nauseum, what I've said before: this isn't a thread about the surgery, but about the discovery found within it, and the possibilities of a non-surgical cure that raises. At some point, if they are serious about discussing the surgery (and I'm becoming more and more convinced that they are not), they'll start a thread about it, and I'll be more than happy to engage them there. Until then - copying from post to post is not frustrating, but easy. :)

Lisa

[Korban]

...At some point, if they are serious about discussing the surgery (and I'm becoming more and more convinced that they are not), they'll start a thread about it, and I'll be more than happy to engage them there. Until then - copying from post to post is not frustrating, but easy. :)

Lisa

To that end I started a thread on it :) Hmmm, at last check not a lot of replies on it... And yes, my thread was started as a feeble attempt to lighten up things in this matter... However, it was not my intent to imply that Bariatric surgery is a light matter.

/smile

[Nancy LC]

That's absolutely true. But neither can those people force me into arguing their points of contention or becoming engaged in their opinions - and those posts were addressed to me personally. To every one of those posts I will simply and politely continue to repeat, ad nauseum, what I've said before: this isn't a thread about the surgery, but about the discovery found within it, and the possibilities of a non-surgical cure that raises. At some point, if they are serious about discussing the surgery (and I'm becoming more and more convinced that they are not), they'll start a thread about it, and I'll be more than happy to engage them there. Until then - copying from post to post is not frustrating, but easy. :)

LisaWell, I guess if you wanted to kill your own thread you found a good way to do it. I'm reminded of that SNL skit, "Talk to the Hand!"

[pennink]

I can't believe what I'm reading!

awriter, you REALLY need to lighten up. You can't FORCE things in life to go your own way. I'm astonished at this.

This board, anyway, has a wonderful give and take and the chance to explore more varied opinions is welcomed.

No one owns a thread. They evolve (think "anyone else sick of reading about oopsies" thread. It became a photoshop extravaganza and what could have been nasty was a riot!)

Yes, you have a right to discuss what you want. If we're not giving you that, you, too, have the right to go elsewhere.

Please accept that we might not fit into the box you've drawn for this thread.

[DrH]

Thank you for saying this! I think someone needs a good roll around in the hay! :lol:



I can't believe what I'm reading!

awriter, you REALLY need to lighten up. You can't FORCE things in life to go your own way. I'm astonished at this.

This board, anyway, has a wonderful give and take and the chance to explore more varied opinions is welcomed.

No one owns a thread. They evolve (think "anyone else sick of reading about oopsies" thread. It became a photoshop extravaganza and what could have been nasty was a riot!)

Yes, you have a right to discuss what you want. If we're not giving you that, you, too, have the right to go elsewhere.

Please accept that we might not fit into the box you've drawn for this thread.

[Nancy LC]

A roll in the hay? I'll take one! Got any cute farmers available?

[DrH]

LOL Nancy!!!



A roll in the hay? I'll take one! Got any cute farmers available?

[awriter]

Well, I guess if you wanted to kill your own thread you found a good way to do it.

Nancy,

As far as I'm concerned, the thread was 'killed' by you and a few others who, rather than *ever* responding to what I actually wrote when I began the thread, hijacked it rather than start their own. It would have been one thing for you to first respond to what I wrote and then add other comments - but you chose not to do that. Fine. Free Country. But it's equally free for me to refuse to be bullied by you or anyone else who feels they have a right to respond as they choose - but whose noses get put out of joint when someone else with whom you don't agree does so.

I'm reminded of that SNL skit, "Talk to the Hand!"

If only! <g>

Lisa

[RobLL]

Nancy,

As far as I'm concerned, the thread was 'killed' by you and a few others who, rather than *ever* responding to what I actually wrote when I began the thread, hijacked it rather than start their own. It would have been one thing for you to first respond to what I wrote and then add other comments - but you chose not to do that. Fine. Free Country. But it's equally free for me to refuse to be bullied by you or anyone else who feels they have a right to respond as they choose - but whose noses get put out of joint when someone else with whom you don't agree does so.



If only! <g>

Lisa

awriter - you have made some useful comments in this thread, but it is also important to figure out the 'culture' of new forums you come into, and probably important to somewhat go along with whatever that culture is. Raised eyebrows and strong exceptions are the more normal way of disagreeing on this site. I hope you stay, but you somewhat have to adapt to us, rather than us to you.

ps I think this a a good enough site, to learn to adapt to. Hope you do too.

[Nancy LC]

Ok, lets try to limit the conversation to what you want.
Last night's 60 Minutes piece on gastric bypass surgery was an eye-opener. Turns out one of the unexpected side effects is that type 2 diabetes in severely obese patients is *instantly* reversed (as in, 4 or so days after surgery) - BEFORE any weight loss occurs. One day a patient is obese and diabetic, the next the patient is still obese but not diabetic. And that reversal now appears to be permanent - that is, a cure.
Yes, I saw some of it too, but was mostly watching something else.

This has struck so many doctors as odd that one doctor in Brazil decided to experiment on diabetic mice. He performed a bypass and diabetes disappeared. Then, to *prove* cause and effect, he reversed the procedure. Diabetes instantly reappeared.
Golly, that's interesting.

Researchers say that it seems that bypassing the duodendum is the key here, but my question is - why? What is it about food going through the stomach (or not) that is changing insulin sensitivity and BS differences in such a major way? What is the biological mechanism in operation here?
I guess we'll have to wait and see!


Currently this surgery is only available to the morbidly obese as a last resort, which is understandable despite the mortality risk statistics major improvement due to new, less invasive techniques. But wouldn't it be wonderful if diabetes researchers find a way to isolate the mechanism and somehow duplicate the results without the surgery? :)

Lisa
Yes. It will be wonderful.

Well, looks like we've about exhausted that subject according to the parameters you've set.

[Cajunboy47]

But of course, that wasn't the point of the 60 Minutes segment or this thread. In those cases the point was to look at the instant remission of diabetes (without any weight loss) caused by this surgery and to begin to ask why, so that perhaps a cure can be found that doesn't include any surgery at all.

Instant remission perhaps, but can you believe everything you hear on TV?? That 60 minutes piece was promoted by somebody, so it is more than likely biased information.

Also, trade the remission for what........? Gastric by-pass is proven to lower iron absorption, that is a side effect of the surgery. Patients who get the surgery have to sign a document saying they were told this before they can have the surgery. Poor iron absorption can lead to leukemia, among other health issues. I'll take my chances with the diabetes and no surgery, if I had to make such a choice and knowing what I know about it all.....

[ppuffy3859]

I can't believe what I'm reading!

awriter, you REALLY need to lighten up. You can't FORCE things in life to go your own way. I'm astonished at this.

This board, anyway, has a wonderful give and take and the chance to explore more varied opinions is welcomed.

No one owns a thread. They evolve (think "anyone else sick of reading about oopsies" thread. It became a photoshop extravaganza and what could have been nasty was a riot!)

Yes, you have a right to discuss what you want. If we're not giving you that, you, too, have the right to go elsewhere.

Please accept that we might not fit into the box you've drawn for this thread.



Oh, Pulllllease! This board is dominated by a few know-it-alls who bully people around all the time-if you're not a walking encyclopedia of lowcarb knowledge, don't even think about posting something that you haven't spent three weeks researching-there are exceptions to this, I've met a few great people on this board, but this is exactly why I stopped posting here-it became a giant yawn to watch the know-it-all veterans of this site stroke themselves with their intellectual discussion of the latest lowcarb theories. Get over it and get on with the diet! And let dissenters have a real voice without being subtly bashed (or not so subtly for that matter). Go AWriter! I think you're right on!**** Stepping back into lurkdome, going back to the "fun" board:)

ETA: Oh, and yes, I did call it a diet, using the word in the sense of what one eats on a daily basis. I know it's a way of life-but I'm sure someone's getting ready to correct me any minute now!

AWriter, I jacked the thread, sorry, just couldn't stand back and watch it...Take care! And PS-I'm type II, and if it could cure me, I'd give it serious consideration! There are "serious" complications associated with ALL surgeries-I had a cardiac arrest w/DIC and coded on the table during my c-section from a very rare, unpredictable complication. Does that mean that people should not have c-sections?! Please!

[gwynne2]

Oh, Pulllllease! This board is dominated by a few know-it-alls who bully people around all the time-if you're not a walking encyclopedia of lowcarb knowledge, don't even think about posting something that you haven't spent three weeks researching-there are exceptions to this, I've met a few great people on this board, but this is exactly why I stopped posting here-it became a giant yawn to watch the know-it-all veterans of this site stroke themselves with their intellectual discussion of the latest lowcarb theories.

I'm hardly a 'veteran' and I rarely state anything as a definitive fact unless it relates directly to my own experience. ("Doing X had Y effect on me personally".) It was just jarring trying to read an otherwise interesting thread when every second post was "No, don't discuss that, discuss this."

I can understand if you're frustrated with the board culture for other reasons, but it wasn't just the 'vets' annoyed by this.

[LessLiz]

The thing I find amazing about the 60 minutes piece is that this is being reported like it is something new and just discovered. It isn't.

To make a long story short, my parents offered to pay for GBP for me in 1992 or 1993. I did a great deal of research, did talk to a surgeon as well as several people who'd had it, and decided to pass. The particular surgeon I talked to was a family friend who did the occasional GBP. The most compelling thing he said was that every Type II diabetic he'd done the surgery on immediately had normal blood glucose levels. This has been reported in the literature on GBP for at least a decade -- I've read journal articles reporting it. But, I never saw any journal article that was written specifically about the reversal of Type II, that was simply one of the points of data covered as a surgical outcome. Additionally, and this is important, *not all patients saw their blood glucose levels return to normal* even when having the same surgery performed by the same surgeon. My (now weak) recollection is that about 20% of people didn't see reversal of Type II, and these people were classed as "severely Type II" because of consistent, exceptionally high blood sugar levels that didn't seem to respond to drugs or diet. (I doubt they were eating a low carb diet!)

Here (http://abcnews.go.com/GMA/OnCall/story?id=4642912&page=1) is a report on duodenal jejunal bypass, which is both reversible and does not cause weight loss. And here (http://clinicaltrials.gov/ct2/show/NCT00562029?term=diabetes+and+New+Rochelle&rank=1) is a study that is being conducted and recruiting volunteers.