Obesity Surgery Can Help Diabetics Live Better Lives….

July 9, 2007

imagesobesir.jpgThe prevalence of Obesity and Diabetes is fast rising with an apparent increase of 60 to 70% within a 10 year period.  The relationship between the two is closely linked which brought a new disease state called: Diabesity or Diabetes plus Obesity!  Two major epidemics in one… result into TROUBLE!  They have the same major problem of lifestyle: improper food intake and plain inactivity and the same kinds of complications long term.

One magic bullet to hit two birds with one stone is the procedure called: Laparoscopic Gastric Banding.  This is a procedure that we now routinely perform in our institution with remarkable success.  It is a less invasive procedure than gastric bypass and has written about its procedure in one post in this website.  In a study done recently, not only did the procedure resulted in weight loss but likewise resulted in changes that reduced the culprit of developing diabetes , hypertension and high cholesterol: the Insulin Resistance State.

Below is the summary of the results of the study from the American Physiological Society Homepage

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   *      prior to surgery, there were expected gender differences in body composition measures. Men were heavier, had greater waist circumferences, and HbA1c( a measure of overall blood sugar control). Women had higher a percentage of body fat.

*      6months after surgery the overall group had a l5 percent reduction in body weight (275 vs. 233 pounds), a 14 percent reduction in BMI (43.4 vs. 37.3), a 13 percent reduction in body fat percentage (49 vs. 43 percent), a 13 percent reduction in waist circumference (53 vs. 46 inches) and a 10 percent reduction in hip circumference (57 vs. 51 inches).

*      six-months after surgery the insulin resistance was reduced 60 percent, according to a HOMA score. This was due primarily to a 50 percent reduction in fasting insulin concentrations with no change in fasting glucose concentrations.

*      there were a few gender differences in surgery-related changes. In women only, the waist-to-hip ratio tended to decrease (0.92 vs. 0.86), and the HbA1c tended to decrease (5.8 vs. 5.6 percent).  Diastolic blood pressured tended to decrease (81 vs. 75 mmHg) and CRP tended to decrease (8.3 vs. 4.7 mg/L).

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The findings are really promising.  If we reduce the state of Insulin Resistance by making a patient lose weight then we unburden our pancreas from over producing insulin in response to our meals. Likewise we therefore reduce a patients risk from developing chronic complications that can cause disability.

The authors concluded that:” These improvements occurred despite the fact that patients were still clinically obese. Rapid improvements in insulin resistance after surgery will have a positive impact on long-term patient health and may delay or prevent progression to diabetes.”

Behavioral Therapy remains the cornerstone of losing weight as well as managing diabetes.  If one can lose weight without invasive procedures through discipline with proper food intake and physical activity…the BETTER! 

But for weight loss remedy beyond the weight loss achieved by behavioral modification that may have lasting long term outcomes especially with regard to risks for chronic complications like heart disease and stroke…then

LAP Banding Is The Way To Go!

For further readings on Lap Banding: The Magic Way To Lose Weight

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4 Responses to “Obesity Surgery Can Help Diabetics Live Better Lives….”

  1. Don Mike Says:

    How many days in the hospital? and approximately how much?

  2. maxim Says:

    Doc, how about the risks?

  3. Doc Gerry Says:

    Mike… usually short stay only and may cost less than P350,000

    Max… risks attributable to anesthesia and operative site infection otherwise pretty safe

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