The Bypass Effect On Diabetes, Cancer

Surgery Can Send Diabetes Into Remission, And May Reduce Risk Of Certain Cancers

(CBS)  The group of patients Stahl met say they all had diabetes before the operation; post-surgery, none have diabetes.

That means they no longer need sugar-control medication, like insulin injections.

One patient, Vicki, told Stahl she went from having eight or nine insulin shots a day to none, and that she's diabetes free - "cured" as she put it.

"Would you use the term 'cure diabetes?'" Stahl asks Dr. Hutcher.

"I think my patients are cured," he says.

"Cured?" Stahl asks.

"Well, they go home on no medication," he says. "And I've followed them now for 10 and 15 years, and see no evidence of recurrence. So, it's pretty darn close."

Studies confirm that about 80 percent of diabetics go into complete remission following the operation. Obesity is considered one of the major causes of type 2 diabetes, but here's something odd: when you have the gastric bypass operation, your diabetes goes away long before you lose the weight.

For Travis, the man who lost 260 pounds in seven months, it took "about a week and a half" before he was rid of diabetes and off all his medication.

Another male patient named Bill said it took him four days. "I went into the hospital on Friday, came home on Monday and dumped my pills," he told Stahl.

This spontaneous remission puzzled Italian surgeon Francesco Rubino, now at New York Presbyterian Weill Cornell Medical Center. "We wanted to know what is making diabetes remit. We thought it could have been something to do with the small bowel," Dr. Rubino says.

So he began performing the bypass on diabetic rats, and realized that when he disconnected the top of the small intestine, an area called the duodenum, the diabetes disappeared. Then, he reversed the operation.

When he reattached it, the diabetes came back.

This was a pivotal discovery. By merely blocking food from traveling through the duodenum, Rubino sent diabetes into remission, proving the effect was independent from weight loss. This meant diabetes could essentially be removed with a scalpel.

Dr. Rubino says this operation has been performed on humans.

60 Minutes joined him in Sao Paulo, Brazil, where clinical trials have begun on diabetics who are not obese, to determine if the "diabetes surgery" is safe and effective.

As of now, if you have diabetes and are not obese you can't have the bypass surgery. Under guidelines written by the National Institutes of Health 17 years ago in 1991, only the severely or morbidly obese are eligible for any bariatric operation. If you're just mildly obese, you can't get it.

"And a lot has changed since 1991," Dr. Hutcher remarks. "I would like to see them change their guidelines, especially for the diabetics. I think we have clear cut evidence that we can do terrific things for diabetes."

[1seattle]

I've went to Mexico when no insurance would cover the lap band x 6 years ago. Have lost 100 pounds and have kept it off. Now have another hiatal hernia and the band doesn't work. Insurance would rather pay for all my diabetic drugs and side effects than pay for a bypass. Absurd. Obesity is the last predjudice we tolerate. We see obese people as fat, rather than for morbid obesity, its a wireing problem. One that the bypass and band turn off. Right now insurance companies cover surgery in 15 states, but not here in Oregon, wa and idaho, mainly run by regence blue shield. Shame on you.
PS for the frequent comments from bypass people that theirs work and so there must be a reason why your bypass doesn't-shame on you too. Their are plenty of reasons that surgeries fail.. Reherniation, pouch enlargement,strictures, poor surgical skills etc. Be kind, you may be there someday.

[mommaterra]

This is absolutely bogus and designed, not for patient health, but for Big Pharma and Mega Medicine profits! Diabetes is never "cured" and to suggest such a thing is unprofessional, at the least. Insulin resistance can be ameliorated, but it comes back without good nutrition. It is tremendously easy to control diabetes, eat meat, preferably fatty meat, whereas it is dangerous and debilitating to undergo gastric bypass -- and the surgery doesn't work for long if it works at all! I know far too many former bypass patients that have no positive effects, but certainly have amassed a wealth of negative ones. No, research this before doing it, really research.

For diabetes, it's easy -- count and control carbohydrate intake. Concentrate on fatty meat. Then be amazed by the numbers. Been here, done this since 1997, and not only are my numbers great, I have more energy than anyone I know. Saturated fat is brain and muscle food!

Two good reference books are "Dr. Bernstein's Diabetes Solution" and Gary Taubes's "Good Calories, Bad Calories," a stupidly-named book full of excellent info. The one caveat for both is that calories are insignificant; carbohydrates are THE issue.

[bobswife87]

My doc referred me to the bariatric surgeon, and I have been through the surgeons evaluation, a psycological evaluation, and a nutritional evalution. It has been proven that I am a candidate for Gastric Bypass. I have type II diabetes, sleep apnea, acid reflux, depression and more. I am on insulin, 2 pill form prescriptions for diabetes, Prilosec, and 3 other prescriptions. I have been fighting with the Trust for my insurance for over a year now to no avail. They come back every time with one thing or another. First it was money, and they found they would save money if I had the surgery, then it was risks and the first medical consultants approved the surgery so they have found another medical consultant in a different state that says the complications are too many and too expensive. Can anyone give me any suggestions?

[davisjoyce]

In April,2002 I had 5 heart bypass surgery and it took a very long time to overcome the stress. In 1994 I was diagnosed with diabetes, high blood pressure, high cholestrol,eye problems, and over weight. My mother died of kidney failure due to complication diabetes. I want to live to see my grand kids and great-grand kids go to school. I am 61 years old and I do not enjoy going to prepare for my own funeral. I want to live! The insurance companies and pharmaceutical companies are run by human beings. They want to live too! Why shorten my life? Medicare,Medicaid,Aetna,and BCBS would not have "baby boomers as a problem" any more "IF" they allow us to get this surgery. Not only allow it, but encourage it! It is the only HUMANE thing to do.

[ranger1948]

deb3256
There are many good surgeons just across the border in Mexico who can perform the tummy tuck at a fraction of the cost here in the U.S. just click on websites for tummy tucks.

[deb3256]

I had RNY Gastric Bypass nearly four years ago and lost 110 pounds! I have gained back 10 pounds since my surgery but completely healed of diabetes, blood pressure problems, sleep apnea, asthma and knee pain! I would like to lose 50 more pounds however cannot find the right diet or program to start losing again. If anyone has any suggestions that has been through gastric bypass please respond to this comment....I feel like a new person but would love to drop these extra pounds! One other thing...my insurance has denied a tummy tuck. This is one side effect, if you will, that should be covered by insurance. With the excess loose skin you will develop a rash and continually have irration around the loose skin. Any suggestions on how to get insurance to cover a tummy tuck if you are having skin irration?

[studboy1965]

Dear CBS,
I saw your story and have been trying hard to get a referal for that bypass surgery. I have been diagnosed with diabetes in Nov 04 and found out that taking zyprexa because a doctor perscribed it to me gave it to me. I get sick and im on the toilet all the time. I want to have the bypass surgery but been having a hard time getting my doctor to refer me to a surgeon. Why wouldnt they want to corrrect a fellow doctors mistake when my insurance covers the proceedure? Im on medicaid and medicare and live in Wisconsin!
Sincerly
Clifford M Johnson

[formerfatty]

I had WLS in June 2002. This June, it will be 6 years. I lost a total of 300 pounds and have kept off every single one of those pounds. In fact, unlike most patients I struggle to maintain my weight, as I lose weight without trying. WLS saved my life. I was 29 when I had this surgery. One thing that I will say is that it is not a gift. WLS is not a magic bullet for weight loss. You need to work hard. You need to change your eating habits and exercise.
I know many people who have had gastric bypass and I know many people who have had a lap band. I know groups of both that have had great success, some success and no success. And after talking to the people who have not lost weight, you learn why. They don''t follow the directions, they don''t exercise, they expect the surgery to do all the work for them.
It is a life long committment. You need to drink water, eat protein, take vitamin supplements, etc. But I personally do not think it is any more than anyone who has not had WLS would need to do.
As for those people who feel that gastric bypass failed them, please review your own habits. See how you are eating and be honest with yourself. Go back to the diet you followed immediately after your surgery. Begin exercising. If you are exercising, then up the amount of time or intensity that you are exercising.
I am 35 years old. I have gotten my life back. Had I not had this surgery 6 years ago, I do not think that I would be here now.

[gamiche1974]

You have to take enough protein, with food AND with supplements if you don''t want to have severe malabsorption. So yes, you failed the surgery. If you had taken 100g of protein everyday, you wouldn''t have those problems today. For the anemia, did you take iron supplements? Enough iron supplements? Good iron supplements that are easily absorbed by gastric bypassers? Did you take your iron on an empty stomach, a couple of hours after any calcium intake?

[jen4381]

I am very dissapointed in the way gastric bypass was presented in this story. I am 5 years post surgery and I have to say that my life has had no improvements, and I did not fail the surgery it failed me. I developed severe malabsorption and have to take vitamin suppositories for the rest of my life, I also developed severe anemia and depression. The problem is the Surgeons don''t want to hear about the bad because all they know how to do is cut. I have been ignored by many dr''s and it wasn''t until I took my health into my own hands that I got well. I think that if cbs is going to do a story on gastric bypass they should present all the information that is out there, not 8 people who don''t have diabetes any longer.

[sonjahoff1]

I am 46, had RNY WLS 9/4/2003, lost 140 pounds, been the same weight 4 years now, what a miracle. Been on a diet since age 6, up and down my whole life. Found out only 3% of people who diet keeps their weight off, I was part of the 97% who failed. Come to find out most overweight people have eating disorders. It would be like telling a drug user you may only have this amount 3 times a day or one little shot of alcohol 3 times a day. Duh, how could that work, same goes for us, we just keep eating. Even those people on TV who lose weight, why don%u2019t you follow up with them in a few years and see how much they gained back?. I find most people can stand to lose 10-50 pounds themselves, why don%u2019t you lose weight and keep it off???? I will be forever grateful for this WLS, yes there are things that could be improved as everything else and they will continue learning and improving this surgery. Until it%u2019s close to perfect, to all the people who don%u2019t know about eating disorders and how I was a walking stroke at heart attack, should wait to comment. I know about 100 people who has had this surgery and even if some of us land up with other issues there is not a single person who would reverse it that I know. For those who don%u2019t work this wonderful tool given to us can consider revering this surgery and gain the weight back you lost plus a whole bunch more. Good Luck.

[omooba1]

60 MINUTES please pass this info.
http://www.grants.gov/search/search.do?&mode=VIEW&flag2006=true&oppId=17506

to Dr. Neil Hutcher from Richmond, Va for consideration.

[spiceteacher]

I agree with Rsweet1957. The insurance companies make the decision easy for alot of potential patients--they won''t pay for the surgery and the average potential patient cannot afford to pay out of pocket.Therefore the patient chooses no surgery. That''s where I am. I have passed all of the necessary pre-tests and have been ok''d, but my insurance co. will not approve the surgery. I cannot afford to pay out of pocket. I question why these insurance co.s do not see that they would be saving money in the long run. If I had the surgery the other health problems would diminish. I guess I will just have to wait and hope that my insurance co. will "wake up" and see the light soon. Until then, I will continue to do all that I can to reduce my weight in other ways just as I have been doing for the last 30 years!

[gamiche1974]

It''s not the surgery who fails the patients...it''s the patients who fail the surgery! Bypass surgery is a tool. You have to work hard, you have to take enough protein, you have to take enough and good vitamins, you have to take enough liquid, you have to eat the right things. If you fail one of those rules, you fail the surgery, not the other way around!

[lynda686]

I''m so disappointed in 60 Minutes!!!
How could you do an info-mercial for surgery without at least giving the negative side of this???
Bad idea.

[ranger1948]

thor134
I became diabetic due to exposure to agent orange in Vietnam. I gained weight after i had to start taking insulin. I tried everything possibole to lose and nothing works. My doctor agrees that a surgery would benefit me. I have not had this surgery becauase i do not like the side effects from it. Get your facts straight before you start making judgements.

[diabetic14]

I am a diabetic, and have been for going on, 7 years. Of course I am Type I diabetic, but that does not matter. I think that more research should be done as well on this issue, but I also think that every person has the right to make their own decisions on this type of surgery as well. I spend almost $1,000 per year on my medicines that I use to control my diabetes, and that is with health insurance. I have had issues with other things as well with a workman''s comp case, and because I had diabetes, I had to go through over 1 1/2 years of extra pain and suffering because I had to prove that it was not diabetic related. If this was a cure or remission for Type I diabetics, I would definitely be looking into it. I think if I knew for sure it would help my diabetes, even with the risks of the surgery, I would find a way to pay for the surgery myself. Good luck to all of you that are Type II diabetics. I wish you the best!!

[notsosuretoo]

Leave it to a surgeon to go off half-cocked and start cutting people with a promise of curing diabetes! 60 minutes has presented an extremely biased, one sided point of view. Where did the opinions quoted come from? From a surgeon who''s lifestyle depends on patients having surgery. If you dig a little deeper, you will find that the complication rate for gastric bypass is a lot higher than you might think. I''m an RN and I have cared for patients who suffer from serious morbidity attributable to gastric bypass surgery, even 5 or 10 years after the procedure (including death). I would like to see some scientific thinking in regards to the new discovery of "bypass effect". Let''s find out WHY it works before we start cutting open diabetics (who have a hard time healing anyway). Anyone considered that there might be a way to replicate the effect WITHOUT surgery? Until we know how and why it works, the very thought of doing surgery on a whim to "cure diabetes" is ludicrous. By the way, have you seen the Biggest Loser? Excercise and diet work just as well as surgery, and don''t subject you to the same dangers. Yes, bypass surgery may be necessary for some morbidly obese persons, but I for one am offended by 60 Minutes incinuation that gastric bypass is THE answer. You can do better CBS!

[rsweet1957]

I am sorry I missed this story, but reading it was reassuring. I had surgery in November 2007 and have lost nearly 90 pounds. The co-morbidities I had (diabetes, high blood pressure and sleep apnea) have significantly diminished or are completely gone as a result of this surgery. I struggled all of my life with obesity and have tried most diets. But, with the insidiousness of diabetes, weightloss was becoming increasingly out of reach. This surgery changed my life.

[nursedeb3]

As a registered nurse who cares for a large number of gastric bypass surgery patients, I was very disappointed by the lack of research done by 60 Minutes and the one-sided reporting that failed to examine the frequent side effects and complications associated with this surgery. Many patients gain back all of their weight and more, while others suffer from malnutrition, dehydration, "dumping syndrome" and cross addictions such as alcoholism. Gastric bypass surgery is not a cure for obesity. Patients need to change their diet and lifestyle for permanent results. I expected more from the reporters of 60 Minutes than this misleading story.