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April 13, 2007 (Seattle) - A bariatric surgery procedure used for treating severe obesity is now being explored as a cure for type 2 diabetes mellitus in normal-weight and moderately overweight patients with diabetes. Specific recommendations for using surgery in these patients are expected to appear this summer, according to a presentation here at the annual meeting and clinical congress of the American Association of Clinical Endocrinologists.

When used as a last resort for weight management, certain gastric bypass procedures have been known to completely reverse, or at least mitigate, type 2 diabetes. Until recently, researchers had assumed that weight loss alone was somehow responsible for this benefit. However, new research in rodents and very preliminary work in humans suggest that hormonal and metabolic changes caused by the surgery must be responsible, not simple weight loss, said Karen Foster- Schubert, MD, acting instructor at the University of Washington in Seattle.

The surgical technique discussed by Dr. Foster-Schubert, Roux-en-Y gastric bypass (RYGB), is one of several procedures indicated for weight reduction. A recent meta-analysis of 22,094 patients showed that 84% experienced complete reversal of type 2 diabetes mellitus, with most stopping their oral medications or insulin injections before leaving the hospital, Dr. Foster-Schubert said.

Drs. Foster-Schubert and Mechanick both expect many patients with type 2 diabetes to want this surgery, despite its inherent risks, including the risk of death. "It's a lot of heartache and headache" to have diabetes, Dr. Foster-Schubert told Medscape. "I expect a pretty large percentage of individuals would be interested, at least in exploring the risks and benefits."

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