13 December 2010

Bariatric Surgery Can Mask Diabetes

Finally, a word of caution on bariatric surgery! Some of us with diabetes have had some serious doubts about the claims by the American Diabetes Association and the American Association of Clinical Endocrinologists on the successes of bariatric surgery for stopping diabetes. Then there is the American Society for Metabolic and Bariatric Surgery endorsement of the procedure which is extremely profitable for its member surgeons.

Now, some practical in your face results are refuting the successes and pointing to a problem of the surgery masking diabetes. Although the numbers are small at this time, doctors are saying that bariatric surgery is not a cure for diabetes. Plus these doctors are calling for long-term following of bariatric surgery patients to track side-effects and mortality rates.

Researchers are now finding flaws in a meta-analysis of 621 studies by Buchwald et al, which concluded that bariatric surgery was a cure for diabetes. Bariatric surgery has been touted as a cure for Type 2 diabetes. Because of decreasing insulin resistance and secretion. Fasting plasma glucose and HbA1c have been used as evidence for that conclusion.

Fasting blood glucose and HbA1c are poor criteria to establish remission of diabetes after surgery. Using glucose tolerance tests and continuous glucose monitoring needs to be considered to make an educated assessment of the glycemic status for this group of patients. Plus postprandial hyperglycemia levels need to be measured.

This blogger warns us of the problems of weight loss surgery (bariatric) here and again here. She also has several other blogs starting in 2008. My one mention is in my blog here – in the third paragraph.

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