Obesity operation may cure diabetes in many

http://www.msnbc.msn.com/id/22787261/

Obesity surgery may cure diabetes
Surgery patients 5 times more likely to see disease disappear, study says
By Carla K. Johnson
The Associated Press
updated 4:03 p.m. MT, Tues., Jan. 22, 2008
CHICAGO - A new study gives the strongest evidence yet that obesity surgery
can cure diabetes.

Patients who had surgery to reduce the size of their stomachs were five
times more likely to see their diabetes disappear over the next two years
than were patients who had standard diabetes care, according to Australian
researchers.

Most of the surgery patients were able to stop taking diabetes drugs and
achieve normal blood tests.

“It’s the best therapy for diabetes that we have today, and it’s very low
risk,” said the study’s lead author, Dr. John Dixon of Monash University
Medical School in Melbourne, Australia.

The patients had stomach band surgery, a procedure more common in Australia
than in the United States, where gastric bypass surgery, or stomach
stapling, predominates.

Gastric bypass is even more effective against diabetes, achieving remission
in a matter of days or a month, said Dr. David Cummings, who wrote an
accompanying editorial in the journal but was not involved in the study.

“We have traditionally considered diabetes to be a chronic, progressive
disease,” said Cummings of the University of Washington in Seattle. “But
these operations really do represent a realistic hope for curing most
patients.”

Diabetes experts who read the study said surgery should be considered for
some obese patients, but more research is needed to see how long results
last and which patients benefit most. Surgery risks should be weighed
against diabetes drug side effects and the long-term risks of diabetes
itself, they said.

The diabetes benefits of weight-loss surgery were known, but the Australian
study in Wednesday’s Journal of the American Medical Association is the
first of its kind to compare diabetes in patients randomly assigned to
surgery or standard care. Scientists consider randomized studies to yield
the highest-quality evidence.

The study involved 55 patients, so experts will be looking for results of
larger experiments under way.

'New way of thinking about diabetes'
“Few studies really qualify as being a landmark study. This one is,” said
Dr. Philip Schauer, who was not involved in the Australian research but
leads a Cleveland Clinic study that is recruiting 150 obese people with
diabetes to compare two types of surgery and standard medical care.

“This opens an entirely new way of thinking about diabetes.”

Obesity is a major risk factor for diabetes, and researchers are furiously
pursuing reasons for the link as rates for both climb. What’s known is that
excess fat can cause the body’s normal response to insulin to go haywire.
Researchers are investigating insulin-regulating hormones released by fat
and the role of fatty acids in the blood.

In the Australian study, all the patients were obese and had been diagnosed
with type 2 diabetes during the past two years. Their average age was 47.
Half the patients underwent a type of surgery called laparoscopic gastric
banding, where an adjustable silicone cuff is installed around the upper
stomach, limiting how much a person can eat.

Both groups lost weight over two years; the surgery patients lost 46 pounds
on average, while the standard-care patients lost an average of 3 pounds.

Blood tests showed diabetes remission in 22 of the 29 surgery patients
after two years. In the standard-care group, only four of the 26 patients
achieved that goal. The patients who lost the most weight were the most
likely to eliminate their diabetes.

Both patient groups learned about low-fat, high-fiber diets and were
encouraged to exercise. Both groups could meet with a health professional
every six weeks for two years.

The death rate for stomach band surgery, which can cost $17,000 to $20,000,
is about 1 in 1,000. There were only minor complications in the study.
Stomach stapling has a 2 percent death rate and costs $20,000 to $30,000.

In the United States, surgeons perform more than 100,000 obesity surgeries
each year.


The American Diabetes Association is interested in the findings. The group
revises its recommendations each fall, taking new research into account.

“There is a growing body of evidence that bariatric surgery is an effective
tool for managing diabetes,” said Dr. John Buse of the University of North
Carolina School of Medicine in Chapel Hill, the association’s president for
medicine and science.

“It’s just a question of how effective is it, for what spectrum of
patients, over what period of time and at what cost? Not all those
questions have been answered yet.”

Medical devices used in the study were provided by the manufacturers, but
the companies had no say over the study’s design or its findings, Dixon
said.

On 23 Jan 2008 02:20:24 -0000, heather@nothing.com (Heather) wrote:

Lose 150 pounds!!!!


Shoot a troll.

LV

"I rode a tank and held a general's rank
When the blitzkrieg raged and the bodies stank."

---Sympathy for the Devil-The Rolling Stones
--------------------------------------------
"A fanatic cannot change his mind and will not
change the subject."

---Winston Churchill
----------------------------------------------

On Tue, 22 Jan 2008 23:36:22 -0800 (PST), Kurt
<kurtwheeling1965@hotmail.com> wrote:

>There is a common saying in here that diabetes can't be cured. In
>most cases it cannot. However, I've heard from more than one diabetes
>specialist (endo) that in the case as mentioned above, it does
>"disappear"...for a lack of a better term. Many here will disagree,
>but call the ADA and ask them about it.
>
>Kurt

You may have a point (it's OK Kurt, we do agree
sometimes:-).

This appears in DIABETES CARE, VOLUME 31, SUPPLEMENT 1,
JANUARY 2008

"Gastric reduction surgery can be an effective weight loss
treatment for obesity and may be considered in people with
diabetes who have BMI >= 35 kg/m2. A metaanalysis of studies
of bariatric surgery reported that 77% of individuals with
type 2 diabetes had complete resolution of diabetes
(normalization of blood glucose levels in the absence of
medications), and diabetes was resolved or improved in
86% (23). In the Swedish Obese Subjects study, a 10-year
follow-up of individuals undergoing bariatric surgery, 36%
of subjects with diabetes had resolution of diabetes
compared with 13% of matched control subjects (24). All
cardiovascular risk factors except hypercholesterolemia
improved in the surgical patients".

Personally, I still believe that my long-term health was
better served by losing my excess without surgery. But for
some surgery may be the only option.

To select who is suitable, I'm not certain that BMI should
be the major criteria. We have had several posters here who
were way over a BMI of 35 who have succeeded with
determination and guts (no pun intended). In many cases the
cause of morbid obesity would appear to be more
psychological than medical. But that's just my opinion.

As a separate aspect, this part concerns me in the study
mentioned in the opening post: "Both patient groups learned
about low-fat, high-fiber diets". One wonders whether the
control group, which only lost an average of 3 pounds
compared to 46, would have had different results with a
different dietary approach.


Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com
Latest: The Diabetes Revolution?

Heather wrote:
> http://www.msnbc.msn.com/id/22787261/
>
> Obesity surgery may cure diabetes
> Surgery patients 5 times more likely to see disease disappear, study says
> By Carla K. Johnson
> The Associated Press
> updated 4:03 p.m. MT, Tues., Jan. 22, 2008
> CHICAGO - A new study gives the strongest evidence yet that obesity surgery
> can cure diabetes.
>
> Patients who had surgery to reduce the size of their stomachs were five
> times more likely to see their diabetes disappear over the next two years
> than were patients who had standard diabetes care, according to Australian
> researchers.
>
> Most of the surgery patients were able to stop taking diabetes drugs and
> achieve normal blood tests.
>
> “It’s the best therapy for diabetes that we have today, and it’s very low
> risk,” said the study’s lead author, Dr. John Dixon of Monash University
> Medical School in Melbourne, Australia.
>
> The patients had stomach band surgery, a procedure more common in Australia
> than in the United States, where gastric bypass surgery, or stomach
> stapling, predominates.
>
> Gastric bypass is even more effective against diabetes, achieving remission
> in a matter of days or a month, said Dr. David Cummings, who wrote an
> accompanying editorial in the journal but was not involved in the study.
>
> “We have traditionally considered diabetes to be a chronic, progressive
> disease,” said Cummings of the University of Washington in Seattle. “But
> these operations really do represent a realistic hope for curing most
> patients.”
>
> Diabetes experts who read the study said surgery should be considered for
> some obese patients, but more research is needed to see how long results
> last and which patients benefit most. Surgery risks should be weighed
> against diabetes drug side effects and the long-term risks of diabetes
> itself, they said.
>
> The diabetes benefits of weight-loss surgery were known, but the Australian
> study in Wednesday’s Journal of the American Medical Association is the
> first of its kind to compare diabetes in patients randomly assigned to
> surgery or standard care. Scientists consider randomized studies to yield
> the highest-quality evidence.
>
> The study involved 55 patients, so experts will be looking for results of
> larger experiments under way.
>
> 'New way of thinking about diabetes'
> “Few studies really qualify as being a landmark study. This one is,” said
> Dr. Philip Schauer, who was not involved in the Australian research but
> leads a Cleveland Clinic study that is recruiting 150 obese people with
> diabetes to compare two types of surgery and standard medical care.
>
> “This opens an entirely new way of thinking about diabetes.”
>
> Obesity is a major risk factor for diabetes, and researchers are furiously
> pursuing reasons for the link as rates for both climb. What’s known is that
> excess fat can cause the body’s normal response to insulin to go haywire.
> Researchers are investigating insulin-regulating hormones released by fat
> and the role of fatty acids in the blood.
>
> In the Australian study, all the patients were obese and had been diagnosed
> with type 2 diabetes during the past two years. Their average age was 47.
> Half the patients underwent a type of surgery called laparoscopic gastric
> banding, where an adjustable silicone cuff is installed around the upper
> stomach, limiting how much a person can eat.
>
> Both groups lost weight over two years; the surgery patients lost 46 pounds
> on average, while the standard-care patients lost an average of 3 pounds.
>
> Blood tests showed diabetes remission in 22 of the 29 surgery patients
> after two years. In the standard-care group, only four of the 26 patients
> achieved that goal. The patients who lost the most weight were the most
> likely to eliminate their diabetes.
>
> Both patient groups learned about low-fat, high-fiber diets and were
> encouraged to exercise. Both groups could meet with a health professional
> every six weeks for two years.
>
> The death rate for stomach band surgery, which can cost $17,000 to $20,000,
> is about 1 in 1,000. There were only minor complications in the study.
> Stomach stapling has a 2 percent death rate and costs $20,000 to $30,000.
>
> In the United States, surgeons perform more than 100,000 obesity surgeries
> each year.
>
>
> The American Diabetes Association is interested in the findings. The group
> revises its recommendations each fall, taking new research into account.
>
> “There is a growing body of evidence that bariatric surgery is an effective
> tool for managing diabetes,” said Dr. John Buse of the University of North
> Carolina School of Medicine in Chapel Hill, the association’s president for
> medicine and science.
>
> “It’s just a question of how effective is it, for what spectrum of
> patients, over what period of time and at what cost? Not all those
> questions have been answered yet.”
>
> Medical devices used in the study were provided by the manufacturers, but
> the companies had no say over the study’s design or its findings, Dixon
> said.
>
>
>
A tape worm can accomplish the same thing. They consume most of the
calories you eat.

--
Blattus Slafaly ? 3 7/8

On Wed, 23 Jan 2008, "Blattus Slafaly £ ¥ 0/00 " wrote:

> A tape worm can accomplish the same thing. They consume most of the calories
> you eat.

Sounds line fun, where do I get one... Just one... Don't want any more
then that.

Alan S <loralgtweightandcarbs@gmail.com> wrote in part:

>As a separate aspect, this part concerns me in the study
>mentioned in the opening post: "Both patient groups learned
>about low-fat, high-fiber diets". One wonders whether the
>control group, which only lost an average of 3 pounds
>compared to 46, would have had different results with a
>different dietary approach.

Ain't it the truth.

There is a cure for maybe most type 2's, and it is extreme weight loss.
--
Jim Chinnis Warrenton, Virginia, USA

On Wed, 23 Jan 2008 08:53:01 -0800 (PST), John <jcarney44@verizon.net>
wrote:

>For how long? Does anyone have inspirational stories of t2s that have
>been able to control their DM through exericise and diet alone for
>many years?

Google a guy called Roger Zoul - I think he's 25+ years on that
prescription. Haven't seen him for a bit, but he wanders in and out of
asd occasionally.

Nicky.
T2 dx 05/04 + underactive thyroid
D&E, 100ug thyroxine
Last A1c 5.6% BMI 25

The Master wrote:
> On Wed, 23 Jan 2008, "Blattus Slafaly £ ¥ 0/00 " wrote:
>
>> A tape worm can accomplish the same thing. They consume most of the
>> calories you eat.
>
> Sounds line fun, where do I get one... Just one... Don't want any more
> then that.

Call your local pet store. Good thing about a tape worm, you can keep
eating all that junk food and loose weight.

--
Blattus Slafaly ? 3 7/8

"Kurt" <kurtwheeling1965@hotmail.com> wrote in message
news:5b8f53cd-a1e9-485c-af75-9a4e8fef13d1@k2g2000hse.googlegroups.com...
>
> There is a common saying in here that diabetes can't be cured. In
> most cases it cannot.

A lot depends upon when in the course of the disease you intervene and (to a
lesser extent) the age of the patient. The important thing to remember is
that type II diabetes is a progressive disease, with different sorts of
pathology going on at different stages of the disorder. Certainly, once you
have the beta cell collapse you see in the later stages nothing that doesn't
involve a pancreas transplant is going lead to a "cure", but if a reasonably
young patient can lose significant amounts of weight at an early point in
the disease process then he or she can indeed be "cured" in every practical
sense of the term. It's insulin resistance that leads to continued
progression of the disease, so the key is improving insulin sensitivity as
quickly as possible. By far the best way to do this (at least a present) is
through weight loss.

Despite the media hype that this paper is getting, there is nothing
particularly new about these results, by the way. In the mid 1990's there
was a paper published who's title was something like "Who'd have thought:
An operation turns out to be the best treatment for type II diabetes". The
paper was based upon a case series, so it wasn't the best quality of
evidence. However, the diabetes results from the Swedish Obese Subjects
trial (the largest well-controlled study of WLS to date) have been around
since at least the early 2000's, and they clearly show that
surgically-weight loss can lead to complete resolution of type II diabetes
in a significant number of cases.

On Wed, 23 Jan 2008 12:18:13 -0800 (PST), dorsy1943
<dtms69@usadatanet.net> wrote:

>There are
>traditional cultures all over the world which eat mostly grains and
>vegetables, little protein and fat, and do not have our rate of
>degenerative diseases.

Only when they're active enough to overcome the insulin resistance
that such a diet brings, assuming you mean diabetes by "degenerative
diseases". Perhaps you ought to check, for instance, the rate of
stroke amongst the Japanese people.

Nicky.
T2 dx 05/04 + underactive thyroid
D&E, 100ug thyroxine
Last A1c 5.6% BMI 25

On Wed, 23 Jan 2008 12:18:13 -0800 (PST), dorsy1943
<dtms69@usadatanet.net> wrote:

>> Depending on amount of damage I can believe low carbing and lap
>> band surgery can acheive the small type of cure. *It's called
>> "controlling with diet". *I've encountered plenty of folks who have
>> been able to pull it off. *Enough damage and diet isn't enough. *But
>> who can ever return to their diet before diagnosis?
>
>Pritikin and others would disagree that the cause of t2 is too many
>carbs. He claimed it was too much fat which caused insulin
>resistance. I do not think that whole food carbs,(not highly
>processed industrial food) would ever cause diabetes. There are
>traditional cultures all over the world which eat mostly grains and
>vegetables, little protein and fat, and do not have our rate of
>degenerative diseases.
>
>Dolores

Would you like to list those cultures? I don't doubt that
some exist, in the same way as other extreme dietary
cultures like the Eskimo exist, but there are usually other
factors of lifestyle complementing the dietary limitations.

Pritikin is not a dietary advisor I would take seriously on
a diabetes forum.

Incidentally, I don't think anyone apart from you in this
thread has claimed that "the cause of t2 is too many carbs."

Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com
Latest: The Diabetes Revolution?

In alt.support.diabetes Heather <heather@nothing.com> wrote:
> http://www.msnbc.msn.com/id/22787261/

> Obesity surgery may cure diabetes
> Surgery patients 5 times more likely to see disease disappear, study says
> By Carla K. Johnson
> The Associated Press
> updated 4:03 p.m. MT, Tues., Jan. 22, 2008
> CHICAGO - A new study gives the strongest evidence yet that obesity surgery
> can cure diabetes.

> Patients who had surgery to reduce the size of their stomachs were five
> times more likely to see their diabetes disappear over the next two years
> than were patients who had standard diabetes care, according to Australian
> researchers.

[snip]

> Blood tests showed diabetes remission in 22 of the 29 surgery patients
> after two years. In the standard-care group, only four of the 26 patients
> achieved that goal. The patients who lost the most weight were the most
> likely to eliminate their diabetes.

What has actually been achieved is remission of diabetic symptoms, of
the same kind as can be achieved by standard diabetes care
practices. It might turn out to be a cure if it turns out that this
remission lasts for ever. Since it's a relatively new procedure there
is no evidence that it doesn't last a long time because there is no
evidence at all about how long it lasts.

As usual the press is confusing absence of evidence with evidence of
absence and symptomatic remission with cure, and they are being
encouraged in these confusions by those who stand to profit from them.

--
Chris Malcolm cam@infirmatics.ed.ac.uk DoD #205
IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]

In alt.support.diabetes Alan S <loralgtweightandcarbs@gmail.com> wrote:
> On Tue, 22 Jan 2008 23:36:22 -0800 (PST), Kurt
> <kurtwheeling1965@hotmail.com> wrote:

>>There is a common saying in here that diabetes can't be cured. In
>>most cases it cannot. However, I've heard from more than one diabetes
>>specialist (endo) that in the case as mentioned above, it does
>>"disappear"...for a lack of a better term. Many here will disagree,
>>but call the ADA and ask them about it.
>>
>>Kurt

> You may have a point (it's OK Kurt, we do agree
> sometimes:-).

> This appears in DIABETES CARE, VOLUME 31, SUPPLEMENT 1,
> JANUARY 2008

> "Gastric reduction surgery can be an effective weight loss
> treatment for obesity and may be considered in people with
> diabetes who have BMI >= 35 kg/m2. A metaanalysis of studies
> of bariatric surgery reported that 77% of individuals with
> type 2 diabetes had complete resolution of diabetes
> (normalization of blood glucose levels in the absence of
> medications), and diabetes was resolved or improved in
> 86% (23). In the Swedish Obese Subjects study, a 10-year
> follow-up of individuals undergoing bariatric surgery, 36%
> of subjects with diabetes had resolution of diabetes
> compared with 13% of matched control subjects (24). All
> cardiovascular risk factors except hypercholesterolemia
> improved in the surgical patients".

Note that "resolution" here means "remission of diagnostic
symptoms". That is not usually considered to be synomymous with cure,
although the confusion of remission with cure is sometimes encouraged
by those who stand to profit from the confusion.

By the criteria of "resolution" employed in that report, at least
several of us here in asd have "resolved" our diabetes. That's not at
all surprising when you consider that by their criteria 13% of their
control diabetics without the surgery also "resolved" their diabetes
by means of "standard daibetic care".

Ho hum...

--
Chris Malcolm cam@infirmatics.ed.ac.uk DoD #205
IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]

"Alan S" <loralgtweightandcarbs@gmail.com> wrote in message
news:451hp35nbhdg0475c9mcgg8qtae12mugd9@4ax.com...
> On Wed, 23 Jan 2008 12:18:13 -0800 (PST), dorsy1943
> <dtms69@usadatanet.net> wrote:
>
>>> Depending on amount of damage I can believe low carbing and lap
>>> band surgery can acheive the small type of cure. It's called
>>> "controlling with diet". I've encountered plenty of folks who have
>>> been able to pull it off. Enough damage and diet isn't enough. But
>>> who can ever return to their diet before diagnosis?
>>
>>Pritikin and others would disagree that the cause of t2 is too many
>>carbs. He claimed it was too much fat which caused insulin
>>resistance. I do not think that whole food carbs,(not highly
>>processed industrial food) would ever cause diabetes. There are
>>traditional cultures all over the world which eat mostly grains and
>>vegetables, little protein and fat, and do not have our rate of
>>degenerative diseases.
>>
>>Dolores
>
> Would you like to list those cultures? I don't doubt that
> some exist, in the same way as other extreme dietary
> cultures like the Eskimo exist,

I would say the Hunzakuts would be about the only culture that might fit
Dolores' criteria (that I know of).

On 24 Jan 2008 13:33:12 GMT, Chris Malcolm
<cam@holyrood.ed.ac.uk> wrote:

>In alt.support.diabetes Alan S <loralgtweightandcarbs@gmail.com> wrote:
>> On Tue, 22 Jan 2008 23:36:22 -0800 (PST), Kurt
>> <kurtwheeling1965@hotmail.com> wrote:
>
>>>There is a common saying in here that diabetes can't be cured. In
>>>most cases it cannot. However, I've heard from more than one diabetes
>>>specialist (endo) that in the case as mentioned above, it does
>>>"disappear"...for a lack of a better term. Many here will disagree,
>>>but call the ADA and ask them about it.
>>>
>>>Kurt
>
>> You may have a point (it's OK Kurt, we do agree
>> sometimes:-).
>
>> This appears in DIABETES CARE, VOLUME 31, SUPPLEMENT 1,
>> JANUARY 2008
>
>> "Gastric reduction surgery can be an effective weight loss
>> treatment for obesity and may be considered in people with
>> diabetes who have BMI >= 35 kg/m2. A metaanalysis of studies
>> of bariatric surgery reported that 77% of individuals with
>> type 2 diabetes had complete resolution of diabetes
>> (normalization of blood glucose levels in the absence of
>> medications), and diabetes was resolved or improved in
>> 86% (23). In the Swedish Obese Subjects study, a 10-year
>> follow-up of individuals undergoing bariatric surgery, 36%
>> of subjects with diabetes had resolution of diabetes
>> compared with 13% of matched control subjects (24). All
>> cardiovascular risk factors except hypercholesterolemia
>> improved in the surgical patients".
>
>Note that "resolution" here means "remission of diagnostic
>symptoms". That is not usually considered to be synomymous with cure,
>although the confusion of remission with cure is sometimes encouraged
>by those who stand to profit from the confusion.
>
>By the criteria of "resolution" employed in that report, at least
>several of us here in asd have "resolved" our diabetes. That's not at
>all surprising when you consider that by their criteria 13% of their
>control diabetics without the surgery also "resolved" their diabetes
>by means of "standard daibetic care".
>
>Ho hum...

Good point.

To me, cure is a simple word.

If my diabetes was cured I could eat what I like, when I
liked, and my blood glucose levels would never exceed those
of a non-diabetic. I may have to watch my diet like other
people, but for good nutrition and weight management not for
BG management.

At this time my diabetes is "resolved" as you define it,
Chris. Some might call me cured, with fasting and A1c under
6mmol/l. But I caught a virus just after Christmas and a
couple of days of FBG well over 7(126) and PPP's over 8(144)
reminded me I wasn't "cured".


Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com
Latest: The Diabetes Revolution?

On 24 Jan 2008 13:33:12 GMT, Chris Malcolm <cam@holyrood.ed.ac.uk>
wrote:

>In alt.support.diabetes Alan S <loralgtweightandcarbs@gmail.com> wrote:
>> On Tue, 22 Jan 2008 23:36:22 -0800 (PST), Kurt
>> <kurtwheeling1965@hotmail.com> wrote:
>
>>>There is a common saying in here that diabetes can't be cured. In
>>>most cases it cannot. However, I've heard from more than one diabetes
>>>specialist (endo) that in the case as mentioned above, it does
>>>"disappear"...for a lack of a better term. Many here will disagree,
>>>but call the ADA and ask them about it.
>>>
>>>Kurt
>
>> You may have a point (it's OK Kurt, we do agree
>> sometimes:-).
>
>> This appears in DIABETES CARE, VOLUME 31, SUPPLEMENT 1,
>> JANUARY 2008
>
>> "Gastric reduction surgery can be an effective weight loss
>> treatment for obesity and may be considered in people with
>> diabetes who have BMI >= 35 kg/m2. A metaanalysis of studies
>> of bariatric surgery reported that 77% of individuals with
>> type 2 diabetes had complete resolution of diabetes
>> (normalization of blood glucose levels in the absence of
>> medications), and diabetes was resolved or improved in
>> 86% (23). In the Swedish Obese Subjects study, a 10-year
>> follow-up of individuals undergoing bariatric surgery, 36%
>> of subjects with diabetes had resolution of diabetes
>> compared with 13% of matched control subjects (24). All
>> cardiovascular risk factors except hypercholesterolemia
>> improved in the surgical patients".
>
>Note that "resolution" here means "remission of diagnostic
>symptoms". That is not usually considered to be synomymous with cure,
>although the confusion of remission with cure is sometimes encouraged
>by those who stand to profit from the confusion.
>
>By the criteria of "resolution" employed in that report, at least
>several of us here in asd have "resolved" our diabetes. That's not at
>all surprising when you consider that by their criteria 13% of their
>control diabetics without the surgery also "resolved" their diabetes
>by means of "standard daibetic care".
>
>Ho hum...

Yes it is ho-hum. Some idiot decided to troll SSFA with this drek and
are snickering to them selves about their mischief.

Remember that if they have a false email address-there is a good
change they are trolling and they aren't even real people.

LV

"I rode a tank and held a general's rank
When the blitzkrieg raged and the bodies stank."

---Sympathy for the Devil-The Rolling Stones
--------------------------------------------
"A fanatic cannot change his mind and will not
change the subject."

---Winston Churchill
----------------------------------------------

On Fri, 25 Jan 2008 02:03:39 GMT, Jim Chinnis
<jchinnis@SPAMalum.mit.edu> wrote:

>Lady Veteran <armyvet@bigfoot.com> wrote in part:
>
>>Yes it is ho-hum. Some idiot decided to troll SSFA with this drek and
>>are snickering to them selves about their mischief.
>>
>>Remember that if they have a false email address-there is a good
>>change they are trolling and they aren't even real people.
>
>Well, I posted in support of the idea. But I've read what others have
>written and I've been influenced by that, too.
>
>I think that for most type-2 diabetics, extreme weight loss will remove the
>insulin resistance. For some, this will be close to a cure. For others, they
>will essentially become better: partially afflicted with type-1 diabetes.


You do not actually understand the differences between type 1 and 2
diabetes do you?

--
Måck©® Deltec CoZmore Pumper
Type 1 since 1975
http://www.alt-support-diabetes.org
http://www.diabetic-talk.org
http://www.insulin-pumpers.org
http://diabetes.niddk.nih.gov/dm/pubs/type1and2/
http://www.pandora.com enter "Jason & Demarco"
http://www.ratbags.com/dechunging/


"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."
....Theodore Roosevelt

(o ô)
--ooO-(_)-Ooo--------------------

"I don't know half of you
half as well as I should like;
and I like less than half of you
half as well as you deserve."
....Bilbo Baggins


DISCLAIMER If you find a posting or message from me
offensive, inappropriate, or disruptive, please ignore it.
If you don't know how to ignore a posting, complain to
me and I will be only too happy to demonstrate...
..

Lady Veteran <armyvet@bigfoot.com> wrote in part:

>Yes it is ho-hum. Some idiot decided to troll SSFA with this drek and
>are snickering to them selves about their mischief.
>
>Remember that if they have a false email address-there is a good
>change they are trolling and they aren't even real people.

Well, I posted in support of the idea. But I've read what others have
written and I've been influenced by that, too.

I think that for most type-2 diabetics, extreme weight loss will remove the
insulin resistance. For some, this will be close to a cure. For others, they
will essentially become better: partially afflicted with type-1 diabetes.
--
Jim Chinnis Warrenton, Virginia, USA

Màck©® <IAM@OneWithTheGoddess.org> wrote in part:

>On Fri, 25 Jan 2008 02:03:39 GMT, Jim Chinnis
><jchinnis@SPAMalum.mit.edu> wrote:
>
>>Lady Veteran <armyvet@bigfoot.com> wrote in part:
>>
>>>Yes it is ho-hum. Some idiot decided to troll SSFA with this drek and
>>>are snickering to them selves about their mischief.
>>>
>>>Remember that if they have a false email address-there is a good
>>>change they are trolling and they aren't even real people.
>>
>>Well, I posted in support of the idea. But I've read what others have
>>written and I've been influenced by that, too.
>>
>>I think that for most type-2 diabetics, extreme weight loss will remove the
>>insulin resistance. For some, this will be close to a cure. For others, they
>>will essentially become better: partially afflicted with type-1 diabetes.
>
>
>You do not actually understand the differences between type 1 and 2
>diabetes do you?

Actually, yes I do.
--
Jim Chinnis Warrenton, Virginia, USA

In alt.support.diabetes on Fri, 25 Jan 2008 02:47:59 GMT in Msg.#
<6djip3lnv3bir2vv6e2sfjmgpsc19umm5g@4ax.com>, Jim Chinnis
<jchinnis@SPAMalum.mit.edu> wrote:

> Màck©® <IAM@OneWithTheGoddess.org> wrote in part:
>
> >On Fri, 25 Jan 2008 02:03:39 GMT, Jim Chinnis
> ><jchinnis@SPAMalum.mit.edu> wrote:
> >
> >>I think that for most type-2 diabetics, extreme weight loss will remove the
> >>insulin resistance. For some, this will be close to a cure. For others, they
> >>will essentially become better: partially afflicted with type-1 diabetes.
> >
> >You do not actually understand the differences between type 1 and 2
> >diabetes do you?
>
> Actually, yes I do.

Jim, which are you? I find the very idea that MOST T2s will have their
insulin resistance removed by extreme weight loss to be completely out of
whack with everything I know about both T1 and T2 diabetes, but then, it's
in itself an extreme statement, and I am leery of extremes, preferring to
try to stay away from blacks & whites.

--
DonnaB shallotpeel

"My life right now is, I wouldn't say reduced to food, but my duties in life
are that I wake up, cook breakfast, clean the dishes, prepare lunch, clean
those dishes, go to the market, get fresh produce, cook dinner, clean those
dishes and then sleep if I can. And I love it. I actually adore it." - Heath
Ledger (04/04/79-01/22/08)

DonnaB shallotpeel <shallotpeel@comcast.net> wrote in part:

>In alt.support.diabetes on Fri, 25 Jan 2008 02:47:59 GMT in Msg.#
><6djip3lnv3bir2vv6e2sfjmgpsc19umm5g@4ax.com>, Jim Chinnis
><jchinnis@SPAMalum.mit.edu> wrote:
>
>> Màck©® <IAM@OneWithTheGoddess.org> wrote in part:
>>
>> >On Fri, 25 Jan 2008 02:03:39 GMT, Jim Chinnis
>> ><jchinnis@SPAMalum.mit.edu> wrote:
>> >
>> >>I think that for most type-2 diabetics, extreme weight loss will remove the
>> >>insulin resistance. For some, this will be close to a cure. For others, they
>> >>will essentially become better: partially afflicted with type-1 diabetes.
>> >
>> >You do not actually understand the differences between type 1 and 2
>> >diabetes do you?
>>
>> Actually, yes I do.
>
>Jim, which are you? I find the very idea that MOST T2s will have their
>insulin resistance removed by extreme weight loss to be completely out of
>whack with everything I know about both T1 and T2 diabetes, but then, it's
>in itself an extreme statement, and I am leery of extremes, preferring to
>try to stay away from blacks & whites.

Hi, Donna.

As far as I know, I am neither. Avoiding black and white is a good idea.

I am just impressed by the evidence that loss of visceral fat can remove the
insulin resistance in many type 2s. For those who still have substantially
normal beta cell function, that's close to a cure. But most type 2s don't
have close to normal beta cell function. Mostly, I think this is because
diagnosis occurs so late in the game.

So, for those with beta cell loss, extreme weight loss should enable them to
dose with less insulin. I.e., they would resemble a mild case of type-1.
--
Jim Chinnis Warrenton, Virginia, USA

In alt.support.diabetes on Fri, 25 Jan 2008 03:24:51 GMT in Msg.#
<b9lip35vrn8ga5bn84m7u45qdr5ohlb8ih@4ax.com>, Jim Chinnis
<jchinnis@SPAMalum.mit.edu> wrote:

> DonnaB shallotpeel <shallotpeel@comcast.net> wrote in part:
> >
> >Jim, which are you? I find the very idea that MOST T2s will have their
> >insulin resistance removed by extreme weight loss to be completely out of
> >whack with everything I know about both T1 and T2 diabetes, but then, it's
> >in itself an extreme statement, and I am leery of extremes, preferring to
> >try to stay away from blacks & whites.
>
> As far as I know, I am neither.

So, you're here for another reason? From another perspective?

> Avoiding black and white is a good idea.

I'm glad we agree about that.

> I am just impressed by the evidence that loss of visceral fat can remove the
> insulin resistance in many type 2s. For those who still have substantially
> normal beta cell function, that's close to a cure. But most type 2s don't
> have close to normal beta cell function. Mostly, I think this is because
> diagnosis occurs so late in the game.
>
> So, for those with beta cell loss, extreme weight loss should enable them to
> dose with less insulin. I.e., they would resemble a mild case of type-1.

And, what of the many T2s who are not on insulin?

I mean, yes, SOME T2s who are diagnosed & on oral meds, can use oral meds,
diet & exercise & get off of the oral meds, or at least off of them for a
time. Does that then mean they are cured? No, everything suggests that it
does not, and that what is happening is actually more of a remission.

And, to simply look at only one function - visceral fat - ignoring all
others, when it is a complicated situation, that again seems to be black &
white, does it not?

--
DonnaB shallotpeel, T2 since June 06, USA

"Brooklyn seems to me the closest thing in America to Europe. The neighbors
and locals are beautiful people. It's like a village." - Heath Ledger
(04/04/79-01/22/08)

DonnaB shallotpeel <shallotpeel@comcast.net> wrote in part:

>In alt.support.diabetes on Fri, 25 Jan 2008 03:24:51 GMT in Msg.#
><b9lip35vrn8ga5bn84m7u45qdr5ohlb8ih@4ax.com>, Jim Chinnis
><jchinnis@SPAMalum.mit.edu> wrote:
>
>> DonnaB shallotpeel <shallotpeel@comcast.net> wrote in part:
>> >
>> >Jim, which are you? I find the very idea that MOST T2s will have their
>> >insulin resistance removed by extreme weight loss to be completely out of
>> >whack with everything I know about both T1 and T2 diabetes, but then, it's
>> >in itself an extreme statement, and I am leery of extremes, preferring to
>> >try to stay away from blacks & whites.
>>
>> As far as I know, I am neither.
>
>So, you're here for another reason? From another perspective?

I've described my situation here before. No time right now.

>> Avoiding black and white is a good idea.
>
>I'm glad we agree about that.
>
>> I am just impressed by the evidence that loss of visceral fat can remove the
>> insulin resistance in many type 2s. For those who still have substantially
>> normal beta cell function, that's close to a cure. But most type 2s don't
>> have close to normal beta cell function. Mostly, I think this is because
>> diagnosis occurs so late in the game.
>>
>> So, for those with beta cell loss, extreme weight loss should enable them to
>> dose with less insulin. I.e., they would resemble a mild case of type-1.
>
>And, what of the many T2s who are not on insulin?
>
>I mean, yes, SOME T2s who are diagnosed & on oral meds, can use oral meds,
>diet & exercise & get off of the oral meds, or at least off of them for a
>time. Does that then mean they are cured? No, everything suggests that it
>does not, and that what is happening is actually more of a remission.

It's possible that--with insulin resistance gone--progression will not
occur. If they are on insulin sensitizers and low-carb, they may be able to
drop the drugs and remain on low carb and not progress. Even if they are on
insulin or insulin analogues they may reduce their demand for insulin enough
to stop the damage to their beta cells--no progression.

>And, to simply look at only one function - visceral fat - ignoring all
>others, when it is a complicated situation, that again seems to be black &
>white, does it not?

I agree that this is a bit black and white. I'm not pushing a view. I have
no horse in this race. And I recognize that there are complexities.

But there is also some truth in the simple picture.
--
Jim Chinnis Warrenton, Virginia, USA

On 23 Jan 2008, "Andrew B. Chung, MD/PhD"
<heartdoc18@emorycardiology.com> posted some
news:8f26e47f-e50a-400c-9886-b697fdf5e599@k39g2000hsf.googlegroups.com:

> Kurt wrote:
>> On Jan 22, 6:20 pm, heat...@nothing.com (Heather) wrote:
>>
>> > http://www.msnbc.msn.com/id/22787261/
>> >
>> > Obesity surgery may cure diabetes
>> > Surgery patients 5 times more likely to see disease disappear,
>> > study says By Carla K. Johnson
>> > The Associated Press
>> > updated 4:03 p.m. MT, Tues., Jan. 22, 2008
>> > CHICAGO - A new study gives the strongest evidence yet that obesity
>> > surgery can cure diabetes.
>> >
>> > Patients who had surgery to reduce the size of their stomachs were
>> > five times more likely to see their diabetes disappear over the
>> > next two years than were patients who had standard diabetes care,
>> > according to Australian researchers.
>> >
>> > Most of the surgery patients were able to stop taking diabetes
>> > drugs and achieve normal blood tests.
>> >
>> > "It's the best therapy for diabetes that we have today, and it's
>> > very low risk," said the study's lead author, Dr. John Dixon of
>> > Monash University Medical School in Melbourne, Australia.
>> >
>> > The patients had stomach band surgery, a procedure more common in
>> > Australia than in the United States, where gastric bypass surgery,
>> > or stomach stapling, predominates.
>> >
>> > Gastric bypass is even more effective against diabetes, achieving
>> > remission in a matter of days or a month, said Dr. David Cummings,
>> > who wrote an accompanying editorial in the journal but was not
>> > involved in the study.
>> >
>> > "We have traditionally considered diabetes to be a chronic,
>> > progressive disease," said Cummings of the University of Washington
>> > in Seattle. "But these operations really do represent a realistic
>> > hope for curing most patients."
>> >
>> > Diabetes experts who read the study said surgery should be
>> > considered for some obese patients, but more research is needed to
>> > see how long results last and which patients benefit most. Surgery
>> > risks should be weighed against diabetes drug side effects and the
>> > long-term risks of diabetes itself, they said.
>> >
>> > The diabetes benefits of weight-loss surgery were known, but the
>> > Australian study in Wednesday's Journal of the American Medical
>> > Association is the first of its kind to compare diabetes in
>> > patients randomly assigned to surgery or standard care. Scientists
>> > consider randomized studies to yield the highest-quality evidence.
>> >
>> > The study involved 55 patients, so experts will be looking for
>> > results of larger experiments under way.
>> >
>> > 'New way of thinking about diabetes'
>> > "Few studies really qualify as being a landmark study. This one
>> > is," said Dr. Philip Schauer, who was not involved in the
>> > Australian research but leads a Cleveland Clinic study that is
>> > recruiting 150 obese people with diabetes to compare two types of
>> > surgery and standard medical care.
>> >
>> > "This opens an entirely new way of thinking about diabetes."
>> >
>> > Obesity is a major risk factor for diabetes, and researchers are
>> > furiously pursuing reasons for the link as rates for both climb.
>> > What's known is that excess fat can cause the body's normal
>> > response to insulin to go haywire. Researchers are investigating
>> > insulin-regulating hormones released by fat and the role of fatty
>> > acids in the blood.
>> >
>> > In the Australian study, all the patients were obese and had been
>> > diagnosed with type 2 diabetes during the past two years. Their
>> > average age was 47. Half the patients underwent a type of surgery
>> > called laparoscopic gastric banding, where an adjustable silicone
>> > cuff is installed around the upper stomach, limiting how much a
>> > person can eat.
>> >
>> > Both groups lost weight over two years; the surgery patients lost
>> > 46 pounds on average, while the standard-care patients lost an
>> > average of 3 pounds.
>> >
>> > Blood tests showed diabetes remission in 22 of the 29 surgery
>> > patients after two years. In the standard-care group, only four of
>> > the 26 patients achieved that goal. The patients who lost the most
>> > weight were the most likely to eliminate their diabetes.
>> >
>> > Both patient groups learned about low-fat, high-fiber diets and
>> > were encouraged to exercise. Both groups could meet with a health
>> > professional every six weeks for two years.
>> >
>> > The death rate for stomach band surgery, which can cost $17,000 to
>> > $20,000, is about 1 in 1,000. There were only minor complications
>> > in the study. Stomach stapling has a 2 percent death rate and costs
>> > $20,000 to $30,000.
>> >
>> > In the United States, surgeons perform more than 100,000 obesity
>> > surgeries each year.
>> >
>> > The American Diabetes Association is interested in the findings.
>> > The group revises its recommendations each fall, taking new
>> > research into account.
>> >
>> > "There is a growing body of evidence that bariatric surgery is an
>> > effective tool for managing diabetes," said Dr. John Buse of the
>> > University of North Carolina School of Medicine in Chapel Hill, the
>> > association's president for medicine and science.
>> >
>> > "It's just a question of how effective is it, for what spectrum of
>> > patients, over what period of time and at what cost? Not all those
>> > questions have been answered yet."
>> >
>> > Medical devices used in the study were provided by the
>> > manufacturers, but the companies had no say over the study's design
>> > or its findings, Dixon said.
>>
>> There is a common saying in here that diabetes can't be cured. In
>> most cases it cannot. However, I've heard from more than one
>> diabetes specialist (endo) that in the case as mentioned above, it
>> does "disappear"...for a lack of a better term.
>
> Cure would be a better term.
>
>> Many here will disagree,
>
>
> Many here are wrong...
>
> ... else they would not have type-2 diabetes.
>
>> but call the ADA and ask them about it.
>
> Simply ask your doctor about it.
>
> It is like s/he will call it a cure when someone no longer needs
> medications to stay euglycemic.

Removal of the head and a ride to a rendering plant would solve both
problems.

On Fri, 25 Jan 2008 02:47:59 GMT, Jim Chinnis
<jchinnis@SPAMalum.mit.edu> wrote:

>Màck©® <IAM@OneWithTheGoddess.org> wrote in part:
>
>>On Fri, 25 Jan 2008 02:03:39 GMT, Jim Chinnis
>><jchinnis@SPAMalum.mit.edu> wrote:
>>
>>>Lady Veteran <armyvet@bigfoot.com> wrote in part:
>>>
>>>>Yes it is ho-hum. Some idiot decided to troll SSFA with this drek and
>>>>are snickering to them selves about their mischief.
>>>>
>>>>Remember that if they have a false email address-there is a good
>>>>change they are trolling and they aren't even real people.
>>>
>>>Well, I posted in support of the idea. But I've read what others have
>>>written and I've been influenced by that, too.
>>>
>>>I think that for most type-2 diabetics, extreme weight loss will remove the
>>>insulin resistance. For some, this will be close to a cure. For others, they
>>>will essentially become better: partially afflicted with type-1 diabetes.
>>
>>
>>You do not actually understand the differences between type 1 and 2
>>diabetes do you?
>
>Actually, yes I do.


Then please clarify:

>>>I think that for most type-2 diabetics, extreme weight loss will remove the
>>>insulin resistance. For some, this will be close to a cure. For others, they
>>>will essentially become better: partially afflicted with type-1 diabetes.



--
Måck©® Deltec CoZmore Pumper
Type 1 since 1975
http://www.alt-support-diabetes.org
http://www.diabetic-talk.org
http://www.insulin-pumpers.org
http://diabetes.niddk.nih.gov/dm/pubs/type1and2/
http://www.pandora.com enter "Jason & Demarco"
http://www.ratbags.com/dechunging/


"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."
....Theodore Roosevelt

(o ô)
--ooO-(_)-Ooo--------------------

"I don't know half of you
half as well as I should like;
and I like less than half of you
half as well as you deserve."
....Bilbo Baggins


DISCLAIMER If you find a posting or message from me
offensive, inappropriate, or disruptive, please ignore it.
If you don't know how to ignore a posting, complain to
me and I will be only too happy to demonstrate...
..

On Fri, 25 Jan 2008 03:24:51 GMT, Jim Chinnis
<jchinnis@SPAMalum.mit.edu> wrote:
>they would resemble a mild case of type-1.


and some people can be a little bit pregnant.

--
Måck©® Deltec CoZmore Pumper
Type 1 since 1975
http://www.alt-support-diabetes.org
http://www.diabetic-talk.org
http://www.insulin-pumpers.org
http://diabetes.niddk.nih.gov/dm/pubs/type1and2/
http://www.pandora.com enter "Jason & Demarco"
http://www.ratbags.com/dechunging/


"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."
....Theodore Roosevelt

(o ô)
--ooO-(_)-Ooo--------------------

"I don't know half of you
half as well as I should like;
and I like less than half of you
half as well as you deserve."
....Bilbo Baggins


DISCLAIMER If you find a posting or me