Study: WLS is not a Diabetes Cure
There's a new study that fails to support the theory that weight loss surgery cures type II diabetes. MedPage Today published an article on it, entitled 'AACE: Bariatric Surgery May Just Mask Diabetes.'
A larger study was posted on the same topic in 2009, there were earlier studies with the same conclusions, and I've always suspected that these studies are right; that WLS doesn't cure diabetes.
We all know what kind of money and influence is behind the people promoting weight loss surgery; the surgeon's groups and the drug companies that manufacture the devices. Surgery candidates want to believe that WLS is worth the risks, because they want the social rewards that come with being thin. If they have or fear getting diabetes, then the claim that WLS "cures diabetes" can be a powerful influence.
But it doesn't really make sense that WLS cures diabetes, does it?
This is how I see it. No doubt it's an oversimplified way of looking at things. I'm not a medical professional, but there are people in my family with type II diabetes and I'm at risk of getting it myself, so I've done a lot of reading.
Type II diabetes is primarily a genetic syndrome, although the easiest way to diagnose and track it is to measure blood sugar. However, if someone can't eat a normal meal - if they're basically starving - then their blood sugar is not going to be high even if they're diabetic. If a diabetic is constantly running a calorie deficit (as they would after WLS), then the fact that their cells aren't responding to insulin - which tells the cells to store fat - isn't really going to matter, because they're losing fat stores, not adding to them. Does that mean that the diabetes is cured? No. As soon as their weight stabilizes and they go back to sometimes using energy and sometimes storing it, then the diabetes will once again become easy to detect.
From the Medpage article:
The researchers also cited flaws in the 621 studies involved in a meta-analysis by Buchwald et al, which concluded that bariatric surgery was a cure for diabetes.
They said most of the studies were retrospective, single-armed, and made up of relatively young women. Also, only 1.6% of them provided Class I evidence.
Marina concluded that HbA1c and fasting blood glucose measurements aren't sufficient criteria to establish a "curing" of type 2 diabetes after gastric bypass surgery.
- The new study-
American Association of Clinical Endocrinologists, Marina AL, Trence DL "Is diabetes mellitus really cured by gastric bypass surgery?" AACE 2010; Abstract 210.
- The older study-
Roslin M, et al "Abnormal glucose tolerance testing following gastric bypass" Surg Obesity Related Dis 2009; 5(3 Suppl): Abstract PL-205.