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Gastric Bypass Can Reverse Diabetes in Teens

Mary Brophy Marcus / USA TODAY

December 30, 2008

Weight loss surgery can reverse diabetes in teens, according to a small study released today in the journal Pediatrics.

Researchers at Cincinnati Children’s Hospital Medical Center and five other medical centers followed 78 teenagers with type 2 diabetes, a condition that occurs when the body doesn’t respond to the hormone insulin, which helps metabolize food into energy. Eleven of the study participants, ages 13 to 21, had gastric bypass surgery — sometimes prescribed for weight loss management in seriously obese people — and the others followed routine management of their diabetes with medicine and lifestyle modifications. All subjects were monitored closely for a year.

All 11 teens who had surgery were at least 100 pounds over the ideal weight for their age and build before the procedure. Within a year after surgery, all but one had dropped about one-third of their body weight and had stopped taking medication for type 2 diabetes, says study author Thomas Inge, associate professor of surgery and pediatrics, and surgical director of the Surgical Weight Loss Program for Teens at Cincinnati Children’s Hospital Medical Center.

“The remarkable thing is that the teens who underwent these procedures did not have any major complications,” Inge says.

The surgery provided patients a number of benefits, he says: The patients came off all diabetic medications, returned to normal blood glucose and insulin levels and significantly improved their blood pressure and cholesterol. Patients who did not have surgery experienced limited health changes for the better.

Two decades ago, type 2 diabetes rarely appeared in adolescents, accounting for only 3% of new cases each year, Inge says. Now it figures in nearly half of all new pediatric type 2 diagnoses.

The study results are impressive, says Michael Freemark, chief of pediatric endocrinology and diabetes at Duke University Medical Center. But he says a number of questions remain, including the long-term benefits and risks to teens. “It’s encouraging, but the results should not at this point be applied in the general community,” he says.

The small surgical group also was not racially diverse, Freemark says.

But Inge says surgery could offer a solution for seriously overweight teens who do not respond to the arsenal of other diabetes treatments — those at highest risk for kidney disease, serious vision problems and nerve damage as early as their 20s and 30s.

“There is no known cure for type 2 diabetes,” Inge says. “This opens up a discussion about what may be appropriate treatment and offers pediatric endocrinologists another tool.”

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