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Reducing heart disease risk for diabetics with stomach surgeries

Are you too fat? If you’re obese and you’ve tried and tried everything but have been unsuccessful in losing weight you could have surgery either to reduce the size of your stomach (lap banding) or to bypass it altogether (gastric bypass).

Bermuda Heart Foundation Executive Director, Simone Barton said for many the procedure would save their lives. Earlier this year, Ms Barton attended the Second World Congress on Interventional Therapies for Type 2 Diabetes held in New York. At that conference the importance of bariatric surgery in reducing the risk of heart disease for diabetics was not only presented but also advocated.

What is bariatric surgery? Surgery to the gastrointestinal tract for the purpose of weight loss.

Dr Francesco Rubino, director of the Congress and director of gastrointestinal metabolic surgery at New York Presbyterian Hospital/Weill Cornell Medical Center, said there are more than 20 years of data to support that there are significant health benefits for those that have the surgery. And he said the most notable was the great reduction in the risk of heart disease.

Ms Barton said that although Type 2 diabetes is not technically a cardiovascular disease, experts at the conference said it might as well be one, given the corrosive effects of unregulated blood sugar on the heart.

“Having diabetes is like having glass shards running through your veins. It literally deteriorates your organs,” she said.

“The issues with diabetes have to be addressed aggressively or else we are going to implode,” she said of the Bermuda situation where an estimated 12 percent of the population has the condition.

According to the American Heart Association, at least 65 percent of people with diabetes die of some form of heart disease or stroke.

At the conference Dr Lars Sjostrom, professor at the Institute of Medicine in Gothenburg, Sweden, presented new data from the Swedish Obese Subjects (SOS) study. The study now has more than 20 years of data comparing 2,010 bariatric surgeries with 2,037 non-surgical patients who received medical treatment or lifestyle modification for obesity.

“Type 2 diabetes has always been considered a chronic, lifelong disease, but the long-term data shows remission in 70 percent of patients after two years of follow-up,” he said in a press release on the study. “Thirty percent are still in remission 15 years after having bariatric surgery. Even more remarkable, 20 years out, we have seen bariatric surgery has reduced new cases of diabetes by 80 percent among obese patients who did not have the disease at the start of the study,” he added.

Dr Sjostrom held that the preventive effect of having bariatric surgery is stronger and longer lasting than its ability to sustain long-term remission.

Also impressive is that patients who had bariatric surgery were 30 percent less likely to have a heart attack or stroke than those patients that were treated by means that did not involve surgery.

A study at the University of Utah had similar results. Dr Ted Adams, the lead investigator in the study said after gastric bypass surgery, patients had greater reductions in blood pressure, heart rate, LDL cholesterol (the bad one), triglycerides (form of fat in the body-elevated levels are associated with obesity) and insulin resistance than patients in the group of severely obese patients who were treated with medication and modifications to their lifestyle.

Dr Adams said the surgical group also experienced favourable changes in their heart function and efficiency.

He said the new data clearly supports the use of bariatric surgery to prevent cardiovascular complications associated with obesity and Type 2 diabetes.

Read Body & Soul next week to discover more on bariatric surgery.

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Published November 22, 2011 at 1:00 am (Updated November 22, 2011 at 8:11 am)

Reducing heart disease risk for diabetics with stomach surgeries

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