The Bypass Effect On Diabetes, Cancer

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





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The Bypass Effect

An operation performed primarily to reduce weight in the obese has some startlingly positive side effects on type 2 diabetes, sleep apnea, high blood pressure, coronary artery disease and even cancer. Lesley Stahl reports. | Share/Embed


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(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."

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Now you're in the public comment zone. What follows is not CBS News stuff; it comes from other people and we don't vouch for it. A reminder: By using this Web site you agree to accept our Terms of Service. Click here to read the Rules of Engagement.

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.
Posted by 1seattle at 5:37 PM : May 21, 2009
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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.
Posted by mommaterra at 3:14 PM : May 13, 2009
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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?
Posted by bobswife87 at 8:10 PM : Apr 23, 2008
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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.
Posted by davisjoyce at 11:42 PM : Apr 22, 2008
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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.
Posted by ranger1948 at 9:30 PM : Apr 22, 2008
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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?
Posted by deb3256 at 9:08 PM : Apr 22, 2008
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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
Posted by studboy1965 at 7:40 PM : Apr 22, 2008
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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.
Posted by formerfatty at 6:21 PM : Apr 22, 2008
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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?

Posted by gamiche1974 at 5:20 PM : Apr 22, 2008
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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.
Posted by jen4381 at 5:09 PM : Apr 22, 2008
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