University research finds potential to reverse diabetes

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University of Minnesota research may have uncovered a key to treating America’s sixth leading killer: diabetes.

Dr. Henry Buchwald , professor of surgery and biomedical engineering, co-authored an article published in this month’s American Journal of Medicine that analyzed more than 600 previous studies and found that major weight loss surgery effectively reversed type II diabetes symptoms in nearly 80 percent of patients.

The findings could lead to a nonsurgical treatment option for diabetics.

More than 23 million Americans suffer from diabetes, according to the Centers for Disease Control and Prevention .

Patients with diabetes have difficulty regulating their blood sugar levels because of a resistance to insulin, the hormone that allows the body to break down glucose in the blood.

Later in life, diabetics are at risk for blindness, neurological problems, numbness in the extremities and cardiac problems.

Type II diabetes — which is generally diagnosed later in life — has been closely linked to obesity.

“Diabetes is a terrible disease,” Buchwald said. “With the bariatric surgery … they essentially become normal.”

Buchwald’s team compiled information on more than 130,000 patients and specifically studied the outcomes of those with diabetes, or about 22 percent.

The incidence rates of diabetes in the general population are about 7.8 percent , according to the CDC.

In order to qualify for a bariatric metabolic surgery, which includes techniques such as stomach stapling and banding, patients must have a body mass index of at least 40, or 35 with the presence of “co-morbidity,” such as diabetes or high blood pressure, he said.

Although the costs for the surgeries range depending on the technique, location and individual provider, Buchwald estimated the procedure to cost about $20,000 to $25,000 . Most insurance companies, including Medicare, cover the costs.

The belief is the surgery changes the production of intestinal hormones, Buchwald said, and that change causes the resolution of the diabetic symptoms. The changes are persistent, he said, and the study shows they have lasted for more than two years.

Buchwald said the ultimate goal is to identify the hormone and translate the knowledge into conventional therapy for all diabetics without the need for surgery.

“We know it’s definitely a function of the amount of weight loss,” he said, meaning that people who lost more weight following the surgery were more likely to have their diabetes resolved.

Another University professor is performing work that goes hand-in-hand with Buchwald’s.

Dr. Sayeed Ikramuddin, associate professor of surgery, is leading a clinical trial site in Minneapolis — one of three worldwide — studying the effectiveness of gastric bypass surgery in patients that would typically be considered unqualified for the procedures, those with a BMI between 30 and 35.

“Many people feel the indications should be expanded,” Ikramuddin said, adding that 6 million diabetics fall within those BMI ranges.

Buchwald said the current standards were set by a National Institutes of Health panel in 1991 and are severely outdated.

Ikramuddin said because most people first develop type II diabetes around a BMI of 31, the results of the clinical trial, paired with Buchwald’s article, “would revolutionize the field.”

—Emma L. Carew is a senior staff reporter.

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