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One doctor's take on how surgery reverses Type 2 diabetes

March 27, 2012|By Eryn Brown, Los Angeles Times / for the Booster Shots blog
  • Santa Monica surgeon Dr. Carson Liu prepares a patient for weight-loss surgery. Liu thinks the surgery helps reverse diabetes by forcing patients to eat more healthfully.
Santa Monica surgeon Dr. Carson Liu prepares a patient for weight-loss… (Brian Vander Brug / Los Angeles…)

On Monday, researchers reported in two new clinical trials that several types of weight-loss surgery were more effective at controlling blood-sugar levels in obese people with diabetes than the usual care regimen of diet and drugs.

In many cases, as Los Angeles Times reporter Melissa Healy wrote Monday (see related items link), surgical procedures to reduce the size and sometimes the placement of the stomach often allowed subjects to discontinue diabetes medications within weeks.

Dr. Carson Liu, a surgeon in Santa Monica who has been performing weight-loss surgeries for more than a decade, said he welcomed the studies. They bore out his experience in his practice: that patients who have gastric bypass and sleeve gastrectomy surgeries (as well as those who have lap-band surgeries with proper follow-up, who weren’t tracked in the clinical trials) have great success reversing their Type 2 diabetes. 

"It’s great to get the word out there," he said. “We want patients to be aware of the options.”

Liu told Booster Shots that he believed the surgeries worked because they forced patients to eat more healthfully, eschewing starchy and sugary food in favor of green vegetables and lean proteins.  “Surgery seems to have better outcomes because it forces patients’ hand on the diet,” he said. “Gastric bypass, the sleeve and the band get people into better habits.”

Diabetes can be controlled through diet and exercise if addressed early enough, Liu added.  But once patients are on medication, they run the risk of slowly poisoning the insulin-producing islet cells in the pancreas, leading to insulin dependence and, often, weight gain. 

For that reason, people with diabetes should act on it — and perhaps get surgery, if they need it to keep them on the right eating track — within five to seven years of their diagnosis if they want to get off of medications, he said. 

 

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