Surgery reverses teen diabetes
2008-12-29 09:01
New York - Obesity surgery can reverse diabetes in teens, just as it does in adults, according to a small study.
All but one of the 11 extremely obese teens studied saw their diabetes disappear within a year after weight-loss surgery, the researchers reported. The 11th patient still had diabetes, but needed much less insulin and stopped taking diabetes tablets.
Previous studies have shown the diabetes benefits of obesity surgery for adults. Dr Thomas Inge, a paediatric surgeon at Cincinnati Children's Hospital Medical Centre, and his colleagues wanted to find out if the same was true for adolescents.
Although more research is needed, Inge said the study "opens the door" to weight-loss surgery as a treatment option for severely obese teens with Type 2 diabetes.
The results are in the January issue of Pediatrics and are being released on Monday.
A third of young people are obese
About a third of US youngsters are either overweight or obese. Increasing numbers of obese children are being diagnosed with Type 2 diabetes, the most common form of the disease and the one linked to obesity. It was seldom seen before in children.
"It's marching south through the generations, which is very scary," said Dr Larry Deeb, a former president of the American Diabetes Association and a spokesperson for the group.
Teen candidates for weight-loss surgery need to be carefully selected, he said, since the long-term consequences of the operation for children are not yet known.
The 11 patients in the study were 14 to 21 years old and all were extremely obese, ranging from 113kg to 183kg. They were taking diabetes tablets and one was on insulin.
At five different medical centres, they had gastric bypass surgery, or stomach stapling, to reduce their stomach to a small pouch.
They were compared to 67 mostly obese teens with diabetes at Cincinnati Children's whose blood sugar was being controlled through diet or medication.
Remission
After one year, those who had surgery had lost between 33kg to 99kg, although none had dropped to a normal weight. For 10 of them, their diabetes was in remission and they stopped taking diabetes medicine.
For the teens who did not have surgery, they all still had diabetes after a year and there was no difference in their weight or their use of diabetes medication. Their blood sugar levels did improve, the researchers said.
As for the one surgery patient whose diabetes was not reversed, the researchers said the reason was not known, but they noted his mother and a younger sibling also had Type 2 diabetes. Three years after the surgery, the teen was no longer overweight, but still needed to take insulin.
Another explanation could be that his diabetes was more advanced than the other teens, Inge said. Adult studies have indicated that the chances of diabetes reversal are better the sooner surgery is done after diagnosis, he said.
"We caught the others in early stage of disease," Inge said. "Did we miss the boat on this one?"
- AP