Post-Surgical Diabetes Remission Called “Top Medical Innovation”

PINEHURST – Raeford resident Rick Sousa knew there was a chance his Type 2 diabetes would go into remission once he’d had weight-loss surgery. Or that he would see enough of an improvement in the disease that he would no longer need medication to control it.

He also knew there was no guarantee of either outcome, but he hoped for the best and got it. Less than a month after his surgery at FirstHealth Moore Regional Hospital, the 45-year-old FirstHealth paramedic started to notice an encouraging change in his blood sugar levels.

“They were slowly going down,” he says.

Except for the two multivitamins he takes daily, Sousa no longer needs any kind of medication. He is completely off his oral diabetes medicine as well as the medication he took to lower his cholesterol and to prevent problems with his blood pressure and kidneys.

“I’m feeling fantastic,” he says.

Since his surgery, Sousa has enjoyed the benefit of what one of the foremost health care systems in the country calls “the top medical innovation for 2013” or, according to the Cleveland Clinic, research showing that bariatric surgery can help control diabetes even when medicine cannot.

In fact, said a recent Cleveland Clinic press release, “many diabetes experts now believe that weight-loss surgery should be offered much earlier as a reasonable treatment option for patients with poorly controlled diabetes – not as a last resort.”

Weight-loss surgeons at Moore Regional Hospital have observed this remission phenomenon (disappearance or lessening of symptoms) time and time again in their patients with Type 2 diabetes. In the 43 bariatric procedures performed at Moore Regional between August 2011 and November 2012, 13 patients had Type 2 diabetes. According to recent clinic records, 12 are now off all of their diabetes medications. 

“Bariatric surgery can have a profound effect on diabetes, and many published studies have looked at the effect,” says bariatric surgeon Raymond Washington, M.D. “Surgery can account for almost an 80 percent remission of diabetes. Oftentimes, patients with non-insulin-dependent diabetes will leave the hospital off of their oral medications after only a few days.”

While it isn’t known exactly why bariatric surgery can have this effect on diabetes, two American Diabetes Association-sponsored researchers have discovered clues that might explain it.

In his research, Christopher Newgard, Ph.D. of North Carolina’s Duke University Medical Institute and the Sara W. Stedman Nutrition and Metabolism Center, found a link between increased circulating concentrations of certain kinds of amino acids (the building-blocks of proteins) and insulin resistance. (Insulin is the hormone that delivers sugar to cells to give them energy. In diabetes, the body does not use insulin properly.)

More recently, Blandine Laferrere, M.D., of St. Luke’s Roosevelt Institute for Health Sciences in New York, observed that patients undergoing bariatric surgery have greatly reduced levels of these amino acids, indicating that the changes are somehow involved in post-surgical diabetes remission.

“Removing the lateral aspect of the stomach induces hormonal and metabolic changes that have a profound effect on insulin and blood glucose,” Dr.Washingtonsays. “This occurs before any significant weight loss and is notable in both gastric bypass and sleeve gastrectomy.”

According to published reports, Dr. Newgard and Dr. Laferrere plan to focus on the effect of amino acids in diabetes in their future research and are hopeful that their preliminary findings could even lead to advancements in diabetes treatments.

Diabetes remission is just one of several benefits that Rick Sousa has experienced since his surgery. “Always a big kid,” he had reached 330 pounds by the time of his surgery. By December 2012, about four months after the operation, he was down to 237 and sporting extra-large T-shirts instead of the quadruple Xes that had been part of his wardrobe.

He can also participate in activities that used to leave him huffing and puffing – like backpacking with his 13-year-old son’s Boy Scout troop.

“They don’t have to wait for me anymore,” Sousa says. “I’m usually in front of them. They have to catch up with me. Depending on how good I feel, I have to wait for them once in a while.”

FirstHealth of the Carolinas offers two information sessions each month on its weight-loss surgery program. For more information, call (800) 213-3284 or visit www.ncweightlosssurgery.org.