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Obesity surgery can lower blood sugars better than drugs -- worth the risk?

By Lindsay Tanner, The Associated Press

Obesity surgery worked much better at reducing and even reversing diabetesthan medication and lifestyle changes in one of the most rigorous studies of its kind. But the researchers and others warn that possible serious complications need to be considered.

The yearlong study indicates that the most common weight-loss surgery, gastric bypass, can effectively treatdiabetes in patients with mild to moderate obesity — about 50 to 70 pounds overweight, the researchers reported Tuesday in the Journal of the American Medical Association.

Other studies have shown the operation can reverse diabetes in severely obese patients, although sometimes the disease comes back.

About a third of the 60 adults who got bypass surgery in the new study developed serious problems within a year of the operation, though some cases were not clearly linked with the surgery. That rate is similar to what's been seen in previous studies.

But for the most serious complications — infections, intestinal blockages and bleeding — the rate was 6 percent, slightly higher than in earlier research.

The most dangerous complication occurred in one patient when stomach contents leaked from the surgery site, leading to an overwhelming infection, leg amputation and brain injury. Lead author Dr. Sayeed Ikramuddin, an obesity surgeon at the University of Minnesota, called that case "a fluke."

A journal editorial says such devastating complications are rare, but that "the frequency and severity of complications ... is problematic" in the study and that the best way to treat patients with both obesity and diabetes "remains unknown."

A research review in the journal said more long-term evidence on risks and benefits is needed to determine if obesity surgery is an appropriate way to treat diabetes in patients who aren't severely obese — at least 100 pounds overweight.

More than 20 million Americans have Type 2 diabetes; most are overweight or obese. Diabetics face increased risks for heart disease and strokes, and poorly controlled diabetes can damage the kidneys, eyes and blood vessels.

About 160,000 people nationwide undergo various types of obesity surgery each year. Bypass surgery, the type studied, involves stapling the stomach to create a small pouch and attaching it to a lower part of the intestines.

The American Society for Metabolic & Bariatric Surgery says obesity surgery is safe and that the death rate is less than 1 percent, lower than for gallbladder and hip replacement surgery.

The study involved 120 patients at five hospitals in New York, Minnesota and Taiwan. All patients got medicines fordiabetes, obesity, cholesterol and/or high blood pressure. They all were advised to cut calories and increase physical activity.

Sixty patients also had surgery, and the two groups were compared after one year.

The surgery group lost on average nearly 60 pounds and 75 percent lowered blood sugar levels to normal or near normal levels. The non-surgery group lost an average 17 pounds and just 30 percent reached the blood-sugar goal. The surgery group also needed less medication after the operation.

The researchers say the diabeteschanges were likely due to the weight loss but that hormonal changes affecting blood sugar may have contributed.

The surgery group showed a trend toward having less high blood pressure and elevated cholesterol — both major risk factors for heart disease, although those between-group differences could have been due to chance.

Ikramuddin, the lead author, said the study results don't mean that all mildly obese diabetics should have obesity surgery, but that "in the correct patient, surgery might be an important thing to consider."

Randy Jackson's Journey with Diabetes

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Schools institute stricter policies on food allergies

Schools institute stricter policies on food allergies

November 1, 2013, AT 7:29 am

By Today Show

Schools across the country have accepted stricter policies on handling food allergies, from training in allergy injector pens to providing non-food incentives. The CDC has posted the full advisory on their website.

Tom Hanks reveals he has type 2 diabetes on 'Late Show'

Tom Hanks reveals he has type 2 diabetes on 'Late Show'

October 8, 2013, AT 6:03 am

By Randee Dawn, TODAY contributor

Tom Hanks on "The Late Show with David Letterman."

When Tom Hanks sat down with David Letterman on Monday's "Late Show," he surprised everyone by making a startling health announcement. He's been diagnosed with type 2 diabetes. 

"I went to the doctor, and he said, 'You know those high blood sugar numbers you've been dealing with since you were 36? Well, you've graduated! You've got type 2 diabetes, young man,'" Hanks told Letterman (click through to the video of last night's show, and start at approximately the 15-minute mark).

"It's controllable," Hanks added quickly. "Something's going to kill us all, Dave."

Letterman said he too suffers from high blood sugar but controls it with diet.

Type 2 diabetes is the most common ofdiabetes, which occurs when the body does not properly metabolize insulin,according to the American DiabetesAssociation.

There was some good news, said Hanks, who was actually on the show to promote his new film "Captain Phillips." The doctor told him if he could maintain his high school weight he could get rid of the diabetes. Hanks said he told the doctor, "Well, I'm going to have type 2diabetes. Because there is no way I can weigh as much as I did in high school.'"

What was his high school weight?

"I weighed 96 pounds," said Hanks. "Most of that was that big white Afro that I wore back in the '70s."'

October 8, 2013, AT 6:03 am

By Randee Dawn, TODAY contributor

Tom Hanks on "The Late Show with David Letterman."

When Tom Hanks sat down with David Letterman on Monday's "Late Show," he surprised everyone by making a startling health announcement. He's been diagnosed with type 2 diabetes. 

"I went to the doctor, and he said, 'You know those high blood sugar numbers you've been dealing with since you were 36? Well, you've graduated! You've got type 2 diabetes, young man,'" Hanks told Letterman (click through to the video of last night's show, and start at approximately the 15-minute mark).

"It's controllable," Hanks added quickly. "Something's going to kill us all, Dave."

Letterman said he too suffers from high blood sugar but controls it with diet.

Type 2 diabetes is the most common ofdiabetes, which occurs when the body does not properly metabolize insulin,according to the American DiabetesAssociation.

There was some good news, said Hanks, who was actually on the show to promote his new film "Captain Phillips." The doctor told him if he could maintain his high school weight he could get rid of the diabetes. Hanks said he told the doctor, "Well, I'm going to have type 2diabetes. Because there is no way I can weigh as much as I did in high school.'"

What was his high school weight?

"I weighed 96 pounds," said Hanks. "Most of that was that big white Afro that I wore back in the '70s."

The ADA Announces Exciting New Diabetes Insurance Changes!

The Affordable Care Act is bringing additional major health insurance changes for people with diabetes over the next few months, including—finally—the end of discrimination against people with diabetes in the health insurance market. No longer can an insurance company stamp “NO” on an application, simply because you or a family member has diabetes.

While these changes will benefit people with diabetes all over the country, we are aware that there is some confusion about how they will benefit you, your friends and your family.

That is why, at the American Diabetes Association, we are bringing you information about the Affordable Care Act to help you get insurance that best meets the needs of you and your family.

There are two important dates to keep in mind:

• On October 1, 2013, people can start signing up for health insurance through their state Marketplace. Coverage purchased in the Marketplace will go into effect as early as January 1, 2014. 
• January 1, 2014 brings a host of other changes including ending discrimination based on diabetes, ending lifetime dollar limits on benefits, and providing financial help to pay for insurance.

We have two new documents to help you understand both Marketplaces and the upcoming changes in health insurance rules related to diabetes. These documents are also available in Spanish.

In the Association’s new Q&A, “The Health Insurance Marketplace and People with Diabetes”, you will find a list of frequently asked questions about the new Health Insurance Marketplace opening in your state on October 1st. If you or anyone you know is uninsured or shopping for new coverage—or simply wants to explore other insurance options—this document will help you learn more about Marketplaces. The American Diabetes Association does not recommend specific health plans, but we want to provide you with an understanding of the new Marketplaces and link you to available resources for assistance. Click HEREto read the Q&A.

The American Diabetes Association’s new “Health Insurance Update: Protections for People with Diabetes” provides information on changes to health insurance rules which impact people with diabetes, including changes that are already in effect and some starting on the first day of the new year. We want to help you understand these changes and how they can benefit you, your friends and family. Click HERE to read the update.

Making sure that people living with, and at risk for, diabetes can access the care they need for optimal health is at the core of the American Diabetes Association’s mission. The new Marketplaces, coupled with the new health insurance rules, will help people with diabetes get the care and treatment they need. Please help spread the word about these changes by forwarding this email to friends and family affected by diabetes.

We appreciate your support and everything you do to Stop Diabetes^®.

Sincerely,

Karen D. Talmadge, PhD Chair of the Board, American Diabetes Association

 

P.S. Those who are seeking assistance in choosing a health insurance plan, or who want to learn more about the Marketplaces, can also visit www.healthcare.gov, or call 1-800-318-2596.

Ramey Nutrition and Dr. Summe: Nutrition in Medicine