Oh My!….Studying the use of major surgery (and calling it a band-aid procedure!!) for those who have a BMI as low as 25!

 

This means if you are 5’5” and weigh 155#….a gastric bypass procedure may be for you???????  

 

Diane Kress’ comments are in RED within the actual article on a study that is enrolling at UTHealth regarding using gastric bypass surgery to manage diabetes for those who are not morbidly obese

 

Released: 3/31/2011 11:45 AM EDT
Source: University of Texas Health Science Center at Houston

Newswise — Physicians at The University of Texas Health Science Center at Houston (UTHealth) have begun enrollment for a pilot study on a promising surgical approach for the management of Type 2 diabetes.

The procedure being tested is designed for adults who have Type 2 diabetes and who are overweight or obese but not morbidly obese. Millions of Americans have Type 2 diabetes and most are overweight. Millions of Americans have insulin imbalance . Insulin is a fat gain hormone and these millions over-produce insulin which makes them overweight. 

Involving surgery to the small intestine and stomach, the procedure, which is called an ileal transposition with sleeve gastrectomy, is intended to improve or resolve Type 2 diabetes.Type 2 Diabetes cannot be resolved…it CAN be controlled but it does not have a cure or go away..   It will be performed at Memorial Hermann-Texas Medical Center.

Type 2 diabetes is a serious health problem and can lead to blindness, limb amputation and heart disease. It is characterized by an elevated blood sugar level associated with the body’s inability to produce enough insulin and/or to use it properly.

The researchers’ goal is to enhance the ability of a person with Type 2 diabetes to maintain a normal blood sugar level by moving a section of intestine closer to the stomach and reducing the size of the stomach. What this means is that a section of the small intestine (that absorbs nutrients) is cut and a portion of the stomach is removed.  It is a rewiring of the GI tract and is not addressing the root cause of type 2 diabetes.

Currently, many with Type 2 diabetes must take medication on a daily basis to keep sugar levels in check. The condition of type 2 diabetes does not necessitate medication to keep blood sugar levels in check. When a person’s blood sugar is in the normal range, he/she will not require any medication for type 2 diabetes.

The surgical procedure has been associated with encouraging results in clinical research conducted abroad. If the procedure proves effective, it could allow some people with Type 2 diabetes to cut back or quit their medications. The procedure will forever cause malabsorption of key nutrients and the size of the stomach will increase over time.  When the stomach pouch increases and the person can increase intake of carbohydrates, blood sugars and weight begin to rise again. 

The objectives of the study include evaluating the safety of the procedure and determining its effectiveness compared to dietary and medical management of Type 2 diabetes.

“No one has compared this surgery directly to medical therapy in a randomized, prospective study like this,” said Brad Snyder, M.D., the principal investigator of the study and an assistant professor of surgery at the UTHealth Medical School.

The UTHealth doctors plan to treat 10 people with Type 2 diabetes surgically and 10 medically. Participants will be followed over a two-year period and their outcomes compared. Wouldn’t it be nice if the 10 people NOT having their bodies permanently rewired were following the Metabolism Miracle lifestyle?  They would end the period in the same (or better) weight and blood sugar range than those who committed to having their body modified.  Two years later, as the surgical patients begin to regain their weight and watch their blood sugar rise, they will end up on MM WITH surgical modification.

“If we can get patients into remission and off their medications, then we could open the door for people who want to pursue careers as firefighters, police officers and commercial pilots who may at times be limited by this disease,” Snyder said. Except less than 2 years later, they will be back in the same boat…with a rewired body.

An estimated 26 million people in the United States have diabetes, reports the Centers for Disease Control and Prevention. In adults, Type 2 diabetes accounts for about 90 -95 percent of all diagnosed cases of diabetes. Also known as adult onset diabetes and non-insulin dependent diabetes mellitus, Type 2 diabetes is associated with older age, physical inactivity and certain ethnic groups. Everyone with uncontrolled type 2 diabetes has uncontrolled Met B.  When they get their insulin under control (MM lifestyle), their diabetes is under control.

“This disease takes a terrible toll on both patients and their families,” said Erik Wilson, M.D., a study investigator and an associate professor of surgery at the UTHealth Medical School. Absolutely true.  I wish UTHealth Medical School would study the Metabolism Miracle instead of focusing on medications and surgery!

The ileum is the final section of the small intestine and transposition means to change place. Human studies have shown that when you place the ileum closer to the stomach, food from the stomach enters the ileum quickly and hormones that help regulate diabetes are easily stimulated. They are removing 5 feet of your small intestine and 80 percent of your stomach!   The hormones that regulate blood sugar are insulin and glucagon are released from the pancreas!  This surgery is modifying your GI tract….forever…..

In the procedure, surgeons remove a section of the ileum that is about 5 feet in length and reattach it. In addition, they remove about 80 percent of the stomach. It is a “band-aid” procedure that is performed through tiny incisions on the abdomen. This band-aid procedure might not leave a huge incision, but inside, it is MAJOR SURGERY.  Don’t be fooled.   As with surgical procedures, there is a risk of complication and the risk is anticipated to be in the 1 to 2 percent range. What about complications that occur out of the “surgical range” time frame?  Deaths and complications that occur 6 months or a year after surgery don’t get attributed to the surgery itself

The procedure is similar to a treatment for morbid obesity – metabolic and bariatric surgery, which can involve surgery on the stomach and intestines. Research shows that oftentimes Type 2 diabetes improves or resolves in morbidly obese patient following gastric bypass surgery. For how long? 

“We’re not completely sure why people with morbid obesity and Type 2 diabetes experience this improvement following surgery,” Snyder said. It could be a combination of the different metabolism of food, the improvement of insulin action or the improvement in insulin secretion, he said. I’m fairly certain that Snyder realizes when you remove some absorptive capacity of nutrients and cut away 80 percent of the stomach….less food can be ingested before a person will vomit it back up.  So….initially, there is no way for the person to eat as much as he used to, and if he tried to, he will experience severe pain, nausea, vomiting and possible rupture of the stomach pouch.”  However, I’m fairly certain he knows that after about 1.5-2 years, the stomach stretches from a few ounces to more than 1 cup and can accommodate rice, pasta, and other high carb foods.  At that time, weight gain returns as does increased blood sugar.

“This research will help us find some answers and could lead to future treatments,” Snyder said. Experimenting on people when you already know the long term outcome is wrong.  Look at the patients with diabetes who have had gastric bypass….follow them 2 years out.  How many are off medications?  How many have not begun to steadily regain weight? 

Metabolic and bariatric surgery is typically limited to people with a body mass index of 40 kg/m² or more, or a BMI of 35 kg/m² or more with an obesity-related condition in accordance with National Institutes of Health (NIH) parameters for bariatric surgery. BMI is a calculation based on height and weight.

This pilot study for the surgical management of Type 2 diabetes is restricted to people with a body mass index (BMI) of 25 to 34 kg/m², which includes people who are overweight or obese. Participants must be between 21 and 55 years of age and being treated for Type 2 diabetes. Every one of these people has uncontrolled Met B.  This surgery does not get to the root of the problem…it just temporarily placates it….and then, they are left back where they were….except they have a rewired GI tract.

The clinical trial team includes Philip Orlander, M.D., a professor of medicine and director of the Division of Endocrinology, Diabetes and Metabolism at the UTHealth Medical School, who medically treats people with Type 2 diabetes. When treating patients, Orlander often begins by recommending they lose weight through conventional means such as restricting their calories and exercising more, as well as taking commonly used medications for diabetes. Restricting calories is NOT the appropriate diet for those with diabetes and it will always fail.  If that fails IT WILL ALWAYS FAIL, Dr. Orlander….and I’m certain you must know that…. and they are eligible for bariatric surgery, Orlander will recommend bariatric surgery as  way to control their Type 2 diabetes. Terrific…how much will this surgery cost in dollars and quality of life for PEOPLE……the answer is not in medication and surgery….it is in balancing insulin/blood sugar….

“The average person with Type 2 diabetes may be on 10 different medications to control their blood sugar, cholesterol and blood pressure,” Oh Yes, Dr. Orlander.  This is because the diet we are promoting is causing their condition to worsen.  Patients on The Metabolism Miracle have medications decreased or removed!  Orlander said. “When we send people to bariatric surgery, a significant portion may be able to stop all of their diabetes, cholesterol and blood pressure medications.”  When someone lives the Metabolism Miracle Lifestyle….they may  be able to stop all their medications forever……without the surgery, its risks, and the inevitable REGAIN AND RETURN TO MEDICATION USE in 2 years.

Frank Moody, M.D., a professor of surgery at the UTHealth Medical School with a longtime interest in the surgical treatment of digestive system diseases I see, a long time INTEREST in the surgical treatment of digestive system disease…..BUT DIABETES IS AN ENDOCRINE SYSTEM DISEASE, is assisting the research team and said the study could shed light on hormones involved in the metabolic process. “The team will be looking at the impact of surgery on the processing of sugars by the diabetic subjects with an expectation of fixing the break in their metabolism,” Moody said. The break in the metabolism is not in digestion/absorption….it is in imbalance of insulin.  Until their insulin/glucagon are normalized, they cannot lose weight or control blood sugar.  Medications don’t do this and surgery does not do this, either!

If successful, the next step could involve a large clinical trial, Snyder said. “Our intention is to gather this primary data in a small group to show the safety and likely significance as well.” Make sure to follow these patients for at least 2 years before you subject a large clinical trial group to this procedure.  At the 2 year mark and beyond…the smoke will clear and everyone will see the results.

Snyder, Wilson and Orlander are collaborating on the study with Kelly Wirfel, M.D., an assistant professor of medicine at the UTHealth Medical School. Snyder and Wilson are members of a UT Specialty Surgery Center called Minimally Invasive Surgeons of Texas (MIST) and are on the medical staff of Memorial Hermann-TMC. Wilson is the director of MIST, chief of Elective General Surgery for the UTHealth Medical School and medical director of Bariatric Surgery for Memorial Hermann-TMC.

The study is titled “A Surgical Approach to the Management of Type 2 Diabetes Mellitus in Patients with a BMI between 25-34 kg/m².” The study was approved by the UTHealth Committee for the Protection of Human Subjects and is anticipated to take about three years to complete.

Those with type 2 diabetes were genetically predisposed to develop diabetes.  These people all have an underlying insulin imbalance.  Insulin is a fat gain hormone and the excess production of insulin caused them to get fat in the blood (cholesterol, triglycerides) and on their body (mid line fat. 

The diet we have recommended for diabetes is highest in the one nutrient that stimulates insulin production….Carbohydrate.  Excess arbohydrate, not calories, is responsible for the progression of diabetes, need for medication, and proliferation of weight gain.

Approximately 2 years after bypass surgery, those who have diabetes stop losing weight and begin to regain weight.  Their medication needs return, too.  So, initially they have improved blood sugar and weight loss because the surgery makes their stomach into a very small pouch.  Once the stomach naturally stretches, its increased capacity allows carb intake in the amount that restarts insulin imbalance and eventually, these patients are back to where they began.  Except…their GI tract is rewired..  I wonder how long after these surgeries a judgement will be made on their success?  They should wait 5 years and the majority of people will be right back at square one. This is because the surgery does not address the root cause of weight gain and blood sugar problems.

It’s one thing to recommend a drastic procedure to those so morbidly obese that time is of the essence and they must lose weight very quickly.  It’s something else to have people who can lose the fat, decrease insulin, and get healthy with the proper lifestyle…..The Metabolism Miracle. 

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About Diane Kress

Author of The New York Times Bestseller; The Metabolism Miracle, The Metabolism Miracle Cookbook, and The Diabetes Miracle. and The Metabolism Miracle, Revised Edition. Owner, developer, and administrator of The Metabolism Miracle's support site: www.Miracle-Ville.com. Registered Dietitian, Certified Diabetes Educator, www.themetabolismmiracle.com www.thediabetesmiracle.com www.miracle-ville.com Email: dietquestions@ymail.com
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2 Responses to Oh My!….Studying the use of major surgery (and calling it a band-aid procedure!!) for those who have a BMI as low as 25!

  1. pine says:

    Wow, your crazy!

    • Diane Kress says:

      Just crazy enough to stick my neck out and tell it like it is! Factual article on my part. It’s time for the medical community to stop steering the public into having surgeries and taking medications that they KNOW don’t work in the long term and may, in fact, cause irreparable damage or death.

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