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Bariatric surgery reduces heart disease risk in diabetics

When you surgically adjust or alter a section of your gastrointestinal tract so that you can lose weight, you are giving yourself a chance to live a more healthy life. This is according to the latest research presented at this year’s World Congress on Interventional Therapies for Type 2 diabetes.

Bermuda Heart Foundation executive director Simone Barton attended the conference and was excited by what this means for many locals.

Bariatric surgery on obese patients with diabetes, has been shown to significantly cut their risk of heart disease. Body & Soul covered that story last week. This week we explain why this surgery works so well. Francesco Rubino, director of the World Congress on Interventional Therapies for Type 2 diabetes and director of gastrointestinal metabolic surgery at New York Presbyterian Hospital/Weill Cornell Medical Centre said the new approach of targetting the gastrointestinal tract to treat diabetes is “highly promising”.

“It represents an entirely new way to treat and think about a disease that is notoriously difficult to control,” he said in a media release.

Dr Rubino said bariatric surgeries, especially ones that involve rerouting the gastrointestinal tract (eg gastric bypass) as opposed to simply restricting it (eg gastric banding), appear to change the secretion of hormones in the gut. He said this was likely the reason bariatric surgeries have been so successful at improving or even resolving diabetes in a majority of patients.

According to Dr Rubino, in surgeries where the upper part of the small intestine is bypassed, the benefits in things like insulin levels, happen too quickly to be a result of weight loss. He said although scientists are still debating the issue, the emerging view is that anatomical changes in the gastrointestinal tract, play a far greater role in controlling diabetes than was previously believed.

Lee Kaplan, an associate professor of medicine at Harvard Medical School is a leading authority on obesity medicine. He also serves as director of the Obesity Research Center at Massachusetts General Hospital and presented at the Congress meeting.

“The pharmaceutical and biotechnology industries have been developing novel diabetes drugs that target the GI (gastrointestinal) tract, but the process is still at a relatively early stage,” he said in a release.

“Recently for example, we have seen the emergence of a new class of drugs designed to alter the action of gut-based hormones such as incretins, which play an important role in the production of insulin,” he said.

Insulin is the hormone that converts sugar to energy in the body. When there is not enough insulin, blood sugar levels rise and diabetes is the result. If cells could be made to produce insulin as the body needed it, diabetes would be easily eradicated.

According to Dr Kaplan there is some evidence of insulin being produced as a result of certain bariatric surgeries.

But the full picture is not yet apparent.

“The molecular character of the upper intestine still remains to be mapped and understood,” he said.

At any rate, because diabetes is a major risk factor for cardiovascular disease, and because bariatric surgery is showing increased success of resolving diabetes, it naturally follows that bariatric surgery also reduces the risk of heart disease for diabetics.

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Published November 29, 2011 at 1:00 am (Updated November 29, 2011 at 8:01 am)

Bariatric surgery reduces heart disease risk in diabetics

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