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April 30, 2005

Other, Research: Cure

Question from Melvindale, Michigan, USA:

I had Roux-en-Y (gastric bypass) surgery in October 2003 and even though my weight loss has slowed down a lot, I'm still very thankful. I've lost just over a hundred pounds and have such better control of my blood sugars and diabetes. It still amazes me daily. Before I had the procedure, a lot of people, most of whom aren't really diabetes educated, kept telling me how great it was going to be when I no longer had to take insulin. I explained to them all that because I'm type 1, I will always have to take some insulin, just not as much as I've had to in the past. I know that a lot of type 2s are able to come off their oral medications, and even injections, after the procedure, but I didn't think they were "cured." I told people my theory, that type 2s are able to come off their medications because their diets are so healthy post-operation, but if they choose to start eating all the "junk" again, they would have to go back to their medications. Most agreed with me, a few said no and my doctor said I'm cured! I saw something on t.v. the other night, in the movie "Super Size Me" where two doctors said flat out that gastric bypass is the only proven way to cure diabetes. They didn't even bother to explain that they were talking about type two, nor the difference between type one and two. So, I guess my question is: how can they possibly make this claim? Am I wrong in that there is still no real cure for either type?

Answer:

You are exactly correct. Type 2 diabetes may be treated with the removal of insulin or pills if enough weight loss in a patient who was previously overweight or obese loses that weight. What happens is that, in type 2 patients, they can still make insulin, but the resistance to the insulin has been removed so that your body works better to move the insulin around. With type 1 diabetes, there is already a deficient amount of insulin. You are correct that if you have type 1 diabetes, you can expect to use less insulin and hope to have better control of your diabetes. Your physician can measure this by seeing what your C-peptide levels are fasting and in response to a food challenge. For every molecule of insulin secreted by your pancreas, there is a molecule of C-peptide generated. In short, I agree with your summary.

JTL