Bypassing diabetes

Geisinger researchers have developed a system that can help predict the chance for successful outcomes for diabetic patients who undergo gastric bypass surgery.

Roux-en-Y gastric bypass (RYGB) has been used to help morbidly obese people lose weight and has been shown to resolve or at least improve Type 2 diabetes in some 60 percent of patients.

But until recently there has been no accurate method to determine which patients have the greatest chance of Type 2 remission after surgery.

Dr. Christopher Still, director of Geisinger’s Center for Nutrition and Weight Management, noted that a simple scoring system, DiaRem, can now predict which patients are likely to achieve remission within five years.

“The DiaRem score will help guide patients and their clinicians in their selection of appropriate treatment and management of Type 2 diabetes,” he said.

The research revealed that the success of gastric bypass surgery for reducing or reversing diabetes can be predicted based on four clinical measures – insulin use, age, measure of blood sugar, and the type of anti-diabetic drugs.

DiaRem scores are determined by a point system assigned to each of the four factors.

“Gastric bypass is known to be very effective for diabetes,” Still said. “This is specifically an equation to predict an individual’s success.”

Gastric bypass surgery results in reducing the amount of food that can be taken in at meals.

The procedure involves reducing the size of the stomach to a small pouch. The pouch is attached directly to the small intestine, bypassing most of the rest of the stomach and the upper part of the small intestine.

Type 2 Diabetes results from the body’s inability to produce sufficient insulin levels. Insulin, a hormone produced by the pancreas, moves sugar from blood to cells to use for energy.

When this process does not work as it should, a person’s blood sugar becomes too high. Diabetes develops when the immune system destroys pancreatic beta cells that produce insulin, according to the American Diabetes Association.

Obesity, diet, and lack of exercise are all common links to diabetes.

Controlling the disease is often done through insulin injections.

“It’s a devastating disease,” Still said. “It’s predicated on diet and exercise. The heavier we are the more chance we have of getting diabetes.”

Diabetes brings increased risk for various health problems, including heart disease and strokes.

More than 20 million Americans have Type 2 Diabetes.

“I think it’s great news,” Still said of the study. “From a clinical standpoint it adds a new dimension to it.”

Still noted that for people with diabetes, bypass surgery is at least something to consider with their physicians.

He noted that people who carefully monitor their blood sugar levels have the best chances of controlling their diabetes.