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  • 26
    Feb
    2013
    5:55pm, EST

    'Amazing' results for diabetes patients after weight-loss surgery

    A new study in the journal Diabetes Care found gastric bypass surgery can have a lasting effect in reversing pancreas damage brought about by Type 2 diabetes. It's further evidence that bypass surgery produces dramatic results unmet by medication alone. NBC's Robert Bazell reports.

    By Robert Bazell, Chief science and medical correspondent, NBC News

    As weight-loss surgery has become more common over the last several years, doctors have had tantalizing clues that certain procedures bring dramatic reduction in type 2 diabetes -- beyond getting their ability to reduce the patient’s weight.

    The surgery appears to have stopped damage to the pancreas, reversing the cause of diabetes as well as alleviating the symptoms, the researchers reported Tuesday in the journal Diabetes Care.

    A year ago researchers at the Cleveland Clinic carried out a careful trial of 150 patients with diabetes that was not being adequately controlled. One-third got gastric bypass, one-third were given a device similar to a lap band that reduces stomach volume, and the rest received the best drug therapies. The goal was to reduce the participants’ blood sugar to below normal levels.

    In the patients who got the bypass surgery the results were dramatic.

    "It's pretty amazing," bariatric surgeon Dr. Philip Schauer of the Cleveland Clinic said at the time. “Many of our patients, even within hours of the operation, their blood sugar becomes normal … even before they've lost any weight at all.”

    The big question was, would the results last? In a one-year follow-up study, published in the journal Diabetes Care on Tuesday, the answer is yes. "Gastric bypass surgery seems to uniquely restore pancreatic beta-cell function, presumably by targeting belly fat and modifying the hormones in the gastrointestinal tract," Dr. Sangeeta Kashyap, an endocrinologist with the Cleveland Clinic, said in a statement. "Gastric bypass remarkably targets belly fat where hormones that are toxic to the body develop."

    Marla Evans a former Type 2 diabetic says within a few days of having gastric bypass surgery her diabetes was much better and within a month or two after surgery she had no trace of diabetes and felt "fabulous emotionally and physically." 

    The pancreas makes insulin, which in turn control blood sugar. People with diabetes can't control their blood sugar as well, and the excess sugar damages organs such as the eyes and kidneys. The pancreas worked again in patients who had the surgery, Kashyap says. "This is something that is very novel and something we don’t see with medications or with insulin," she said.

    A gastric bypass procedure makes the stomach smaller by dividing it into two sections and connects a portion of the small intestine to one of the stomach pouches, reducing the amount of calories absorbed by the body. Curiously, another surgical procedure called sleeve gastrectomy, which also reduced stomach volume, caused the patients to lose just as much weight, but it did not bring the same dramatic reduction in diabetes.

    The doctors are not sure how the bypass surgery changes the hormone balance in the body to cure the diabetes. And they hope someday they might achieve the same effect without the surgery.

    The Cleveland Clinic doctors want to treat more patients before they are confident they have a cure. An estimated 26 million Americans have type 2 diabetes and it has been called one of the fastest-spreading epidemic ever.

    Dr. Sangeeta Kashyap, an endocrinologist at the Cleveland Clinic, says their studies show that bypassing the intestine has powerful benefits on peoples' diabetes and metabolism.

    If it continues to be successful, the main issue will be whether major surgery costing $25,000 -- and often not covered by insurance -- is too drastic a treatment. In response any doctors point out that uncontrolled diabetes often leads to kidney problems, heart attacks, strokes, amputations and death. For many diabetic patients medical costs far exceed $25,000. So, if the diabetes cannot be controlled in other ways, the surgery may become far more common.

    Related:

    Diabetes patients benefit from weight-loss surgery

    High-glycemic foods tied to diabetes risk

    Big rise in diabetes, especially down South

    58 comments

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    Explore related topics: diabetes, featured, gastric-bypass, blood-sugar
  • 10
    Jan
    2012
    11:31am, EST

    All that stress is shrinking your brain, new study finds

    By Rita Rubin

    Everyone knows stress can cause headaches and sleepless nights. But a new study suggests it can actually shrink your brain.

    We’re not talking run-of-the-mill stressors here, like a looming deadline or a missed bus.

    “These are bad things happening, like a relationship breakup, loss of a loved one, being held at gunpoint,” says Yale neurobiologist Rajita Sinha, senior author of the new report.

    Simply feeling stressed-out was not linked to gray matter shrinkage. But feeling stressed-out combined with a history of stressful life events was.  In particular, stress was linked to markedly less gray matter than expected in a part of the prefrontal cortex that regulates emotion and self-control, not to mention blood pressure and blood sugar.

    That shrinkage might serve as a red flag about a greater risk of chronic diseases such as high blood pressure as well as psychiatric disorders, according to the researchers. And maybe it’s already affecting brain function in the healthy individuals she studied, Sinha says.

    In other words, the stresses of modern life are far more complicated than what our ancestors experienced. “You can say stresses are a part of life, so what’s the big deal?” Sinha says. But it is a big deal, she adds, because there’s extensive evidence that stress has contributed to the rise in chronic diseases.

    Most human research about the impact of stress on brain structure has focused on patients with stress-related psychiatric disorders such as addiction and anxiety, according to the authors. Those studies have found decreased volume in the frontal lobe, considered the center of emotion control and personality.

    But studies of the cumulative effects of stress on the brains of healthy people are rare, Sinha’s team writes in a paper published online this week in Biological Psychiatry.

    The study enrolled 103 health adults ages 18 to 48. Researchers conducted structured interviews with the volunteers to collect information about stressful life events and subjective feelings of chronic stress.

    The scientists then used MRI to scan the volunteers’ brains.

    Whose brains shrunk more, men’s or women’s? You might think you know the answer, but the researchers don’t, because they didn’t have enough women to compare the sexes.

    The take-home message, Sinha says, is that the better you cope with stress -- take a walk, call a friend -- the better off your brain will be.

    More like this:

    Men and women really do have big personality differences

    43 comments

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Rita Rubin

Rita Rubin is a contributing health and parenting writer for msnbc.com and TODAY.com. Previously, she covered health and medicine for USA Today and U.S. News and World Report. She is also the author of What If I Have a C-Section?

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