Bariatric Times - December 2008 - (Page 14) 14 Diabetes Perspective Bariatric Times • December 2008 Type 2 Diabetes Mellitus: An Operable Disease? by Ricardo Cohen, MD Dr. Cohen is with the Center for Surgical Treatment of Morbid Obesity and Metabolic Disorders, Baros Surgical Associates, Sao Paulo, Brazil. Continued from Page 1 gastric bypass (RYGB), and 98 percent after biliopancreatic diversion (BPD). T2DM resolution in AGB is proportional to weight loss. The remarkable resolution of diabetes after RYGB and BPD typically occurs too fast to be accounted for by weight loss alone, suggesting that there may be a direct and more profound impact on glucose homeostasis. The antidiabetic effect of bariatric surgery is long-lasting. Long-term control of glycemia and normal levels of glycosylated hemoglobin after RYGB have been documented in large series with up to 14 years of follow-up.2-4 While T2DM is often associated with obesity, this relationship is highly dependent on geographic location. The average body mass index (BMI) of a T2DM patient in the United States is 30, while in India the average is 27. Despite its efficacy with respect to weight loss and resolution of comorbid health conditions, bariatric surgery is, in theory, less desirable for normal or overweight patients. Bariatric operations have occasionally been performed in non-morbidly obese individuals. Cohen et al5 recently published the surgical treatment of 37 patients outside the standard 1991 NIH surgical indications, with BMIs varying from 32 to 35, all with T2DM among other comorbidities. A novel revolutionary concept about an old disease:
Table of Contents Feed for the Digital Edition of Bariatric Times - December 2008 Bariatric Times - December 2008 Table of Contents Patient Management Perspective Diabetes Perspective Interview: ASMBS’s Georgeann Mallory Editorial Message Editorial Board Body Contouring Perspective Meeting Perspective Journal Watch Advertiser Index News & Trends Bariatric Times - December 2008 Bariatric Times - December 2008 - Interview: ASMBS’s Georgeann Mallory (Page Cover1) Bariatric Times - December 2008 - Interview: ASMBS’s Georgeann Mallory (Page Cover2) Bariatric Times - December 2008 - Editorial Message (Page 3) Bariatric Times - December 2008 - Table of Contents (Page 4) Bariatric Times - December 2008 - Table of Contents (Page 5) Bariatric Times - December 2008 - Editorial Board (Page 6) Bariatric Times - December 2008 - Editorial Board (Page 7a) Bariatric Times - December 2008 - Editorial Board (Page 7b) Bariatric Times - December 2008 - Editorial Board (Page 7) Bariatric Times - December 2008 - Editorial Board (Page 8) Bariatric Times - December 2008 - Editorial Board (Page 9) Bariatric Times - December 2008 - Editorial Board (Page 10) Bariatric Times - December 2008 - Editorial Board (Page 11) Bariatric Times - December 2008 - Editorial Board (Page 12) Bariatric Times - December 2008 - Editorial Board (Page 13) Bariatric Times - December 2008 - Editorial Board (Page 14) Bariatric Times - December 2008 - Editorial Board (Page 15) Bariatric Times - December 2008 - Editorial Board (Page 16) Bariatric Times - December 2008 - Editorial Board (Page 17) Bariatric Times - December 2008 - Editorial Board (Page 18) Bariatric Times - December 2008 - Editorial Board (Page 19) Bariatric Times - December 2008 - Body Contouring Perspective (Page 20) Bariatric Times - December 2008 - Body Contouring Perspective (Page 21) Bariatric Times - December 2008 - Body Contouring Perspective (Page 22) Bariatric Times - December 2008 - Body Contouring Perspective (Page 23) Bariatric Times - December 2008 - Meeting Perspective (Page 24) Bariatric Times - December 2008 - Meeting Perspective (Page 25) Bariatric Times - December 2008 - Meeting Perspective (Page 26) Bariatric Times - December 2008 - Meeting Perspective (Page 27) Bariatric Times - December 2008 - Meeting Perspective (Page 28) Bariatric Times - December 2008 - Meeting Perspective (Page 29) Bariatric Times - December 2008 - Journal Watch (Page 30) Bariatric Times - December 2008 - Journal Watch (Page 31) Bariatric Times - December 2008 - Advertiser Index (Page 32) Bariatric Times - December 2008 - News & Trends (Page 33) Bariatric Times - December 2008 - News & Trends (Page 34) Bariatric Times - December 2008 - News & Trends (Page Cover3) Bariatric Times - December 2008 - News & Trends (Page Cover4)
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