January 22, 2013

Intensive Diabetes Intervention May Halt Disease

This is good news in a different way. A cure is not completely promised, but it puts other options into play and means that bariatric surgery has competition. This is great because bariatric surgery has been touted as the cure-all for type 2 diabetes. Gastric bypass has not lived up to its promise as surgeons had promised. Yes, we now know that is not true and more studies are proving this. Diabetes is returning in larger percentages than previously realized and patients are unhappy. Weight is also coming back because of lack of education and lifestyle changes that are not stressed and educated about by the money hungry surgeons.

Now we have another alternative to bariatric and gastric bypass surgery. This is intensive diabetes intervention. This is also something that needs to be viewed with skepticism; however, this is better planned and education is part of the process. What is not talked about is maintaining the enthusiasm for the process and the rate of weight loss. This needs to be a part of the education and part of the continuing education. The biggest advantage is there are no surgery and other invasive medical procedures.

I always become skeptical when researchers claim total remission. When a patient returns to previous bad habits, the diabetes will return. The study here is only for a four-year period. Unless these studies continue, we cannot be sure of the outcome. The article sounds impressive and offers hope of non-surgical success. Sometimes it takes intensive intervention to start things, and I hope that these people get the complete education package they need to succeed.

Remission rates were much higher among:
1. People who lost a great deal of weight
2. People who became considerably fitter
3. People with shorter duration of extant diabetes (those who had not had diabetes for long)
4. People with lower HbA1c at entry and not using insulin”

These points from the study are important. The third and fourth points are probably discouraging for many, but I can understand the why and know that the longer you have diabetes, the less likely remission will be. At least this study shows promise for extending the activity of preventing diabetes into the early stages of diabetes.

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