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weight loss Surgical Weight Loss F Reverse Diabetes with Bariatric Surgery | orget laughter. Surgery may be the best medicine after all, at least when it comes to diabetes. Brenda Storms had struggled for years with the chronic disease, as well as obesity, stemming from her childbearing years. Traditional type 2 diabetes therapy never really helped, nor did exercise regimens for her weight. However, her outlook changed dramatically after she underwent gastric bypass surgery this past June. The 53-year-old Bladen County schoolteacher lost more than 70 pounds in six months and went from a size 20 dress down to a size 11. Even better, she didn't need daily insulin shots and medication anymore for her skyrocketing blood sugar and cholesterol levels. Her blood sugar numbers fell back to normal just two days after surgery. "My endocrinologist was pleased as punch," she said. "I couldn't get my numbers that low when I was on medication." Her success has a poignant side. Storms, a Native American, lost her mother, sister and brother to diabetes, all of whom died in their fifties. Native Americans have one of the highest prevalence rates for diabetes among all U.S. racial and ethnic groups. Doctors say bariatric surgery has become a viable diabetic treatment because of its ability to change patients on a metabolic level. Food is normally absorbed into the bloodstream in the form of sugar, such as glucose. Higher blood sugar signals the pancreas to increase insulin production. The insulin attaches to cells, removing sugar from the bloodstream so it can be used for energy. If a person becomes insulin-resistant, the body's cells are less able take in and to break down sugars. In response to the high circulating blood sugar, the body produces even more insulin. Over time, people with insulin resistance (high insulin By Donnie Byers and high glucose in the blood) can develop type 2 diabetes. Gastric bypass works by stapling the stomach and rerouting the small intestine, so the digestive process is altered and less food is taken in. As a result, the patient loses weight and maintains less sugar in the bloodstream over time. Leo Davidson, M.D., performed Storms' surgery. He said the Lap-Band® and gastric stomach sleeves have also shown promise in treating diabetes. Still, gastric bypass is the better option. "It can reverse diabetic symptoms in patients," Dr. Davidson said, "even before the patient begins losing weight. The bypass changes insulin resistance." Two recent studies published in the New England Journal of Medicine have shown that bariatric surgery often works better than standard type 2 diabetes treatments, among obese and overweight patients with out-of-control blood sugar. The studies found weight-loss surgery patients were also more likely to have a complete remission from diabetes, or to need less medicine, compared to patients who didn't have surgery. Ijeomah Ejeh, M.D., says bariatric surgery is nothing new, but has been steadily refined over the years. Doctors also better understand the physiology behind it now. "You can expect to lose 70 to 80 percent of your excess weight within 18 months," she said. "People who have failed conventional weight loss programs should consider it, especially diabetics." Dr. Ejeh performs lap-banding and gastric bypass surgery but generally recommends bypass surgery for overweight diabetic patients. Lap-banding is reversible, but bypasses takes more weight off faster. "You still have to diet and exercise." Dr. Ejeh continued, "Or you run the risk of your old eating habits creeping back 2013 Medical & Dental Directory | 49

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