Obesity poses a primary risk factor for diabetes, and so losing weight is key to controlling the disease. Patients in the non-surgical group lost weight by instituting lifestyle changes, but they didn't lose nearly as much as those who had the surgery. And those who lost the most weight, ostensibly, became diabetes-free the quickest.

"[Obesity surgery is] the best therapy for diabetes that we have today, and it's very low risk," said study director Dixon in a CNN report. Dr. David Cummings of the University of Washington in Seattle adds, "We have traditionally considered diabetes to be a chronic, progressive disease…But these operations really do represent a realistic hope for curing most patients."

Is it just me, or doesn't it seem counter-intuitive to address a metabolic disease like diabetes by hacking away at the body with a scalpel?

First, let's look at the surgical risk factor. The research subjects in Australia underwent a procedure called stomach banding, in which a silicone band gets implanted around the upper stomach, limiting how much food patients can eat. Stomach banding incurs a fatality rate of one per 1000 operations and is the preferred obesity surgery in Australia. The US medical community usually opts for the more dangerous--and incidentally more expensive (i.e., more profitable) gastric bypass surgery -- with a death rate of one in 200.  In bypass surgery, the stomach gets divided into two sections, with one made into a small pouch that's "stapled" off, thus limiting the amount of food that can be eaten.  At the same time, the small intestines are shortened and attached to the pouch.   

Many believe the fatality rate for gastric bypass surgery actually is much higher than commonly quoted. In older patients who undergo the surgery, the fatality rate soars to 50 percent. Given that most Type 2 diabetes patients fall into the "older" category, these figures hardly inspire confidence. I tend to side with those who claim that death rates from these procedures are underreported-- I personally know of two people who died after gastric bypass surgery.

Potential complications (other than dying) include severe malabsorption of nutrients, malnutrition, bleeding, infection, anemia, gallstones, unstoppable vomiting, and so on. And, for all this risk, the surgery doesn't last. Many patients experience disintegration of the bypass modifications over time. Staples decay, bands closing off the stomach fall apart, the stomach pouch stretches back to its original size, stomach contents leak into the abdomen. When these things occur, the operation must be reversed. What happens to the diabetes risk factor then?
In fact, bypass surgery doesn't cure diabetes -- it simply postpones the appearance of symptoms. Unless you address the actual causes of the disease, all you've done is delayed the reckoning. To be diabetes-free, you have to employ a multi-faceted approach--and bypass surgery ain't one of those facets. In addition to changing your diet and losing weight, you need to:

• Inhibit absorption of high glycemic foods
• Naturally reverse insulin resistance
• Repair beta cells in the islets of Langerhans in the pancreas to optimize insulin production
• Lower blood sugar levels
• Protect organs and proteins from damage caused by elevated levels of insulin and sugar.

The bottom line is that bypass surgery puts you at considerable risk, particularly if you're over 50, and still leaves you vulnerable to diabetes damage. As with most other health issues, you need to take a systemic approach -- not a magic bullet.

:hc