Obesity puts people at risk of developing several health conditions, including Type 2 diabetes. Type 2 diabetes, also called Adult Onset Diabetes, is a chronic condition that can require insulin therapy and is found in people who are obese ten times more frequently than those whose weight is normal. When a person suffers from type 2 diabetes their blood sugar is always elevated. This elevated sugar level damages tissue throughout the body and can lead to kidney failure, heart attack, stroke, blindness and block arteries in the leg occasionally resulting in amputation.

Lifestyle changes specific to diet and exercise are the first line of defense and initial therapy and can also prevent the development of adult onset diabetes. Dr. Christine Ren-Fielding is pleased that there is increasing evidence that weight loss surgery is a highly effective treatment for obese patients with type 2 diabetes. In fact, a two year interim report of the ongoing APEX lap-band study found that 95% of patients saw improved glucose control following the surgery. The breakdown of patients was:

• 5% no longer needed hypoglycemic medication (remission)
• 47% required less medication.

A mere 4.5% saw no changes in glucose control after surgery.

Dr. Christine Ren-Fielding is encouraged that this study is not alone in its findings. Another study considered mildly obese diabetic patients post laparoscopic gastric bypass surgery. The study found that within 26 weeks following the surgery, subjects with a BMI (Body Mass Index) from 30-35:

• 88% were able to stop medications and maintain HbA levels of less than 6.5%
• 11% experienced improved glucose control and were able to stop insulin and/or reduce their medication during the three to 14 weeks after surgery.

While the current cutoff for gastric bypass surgery is a BMI of 35+, Dr. Christine Ren-Fielding hopes that studies such as these may encourage rethinking of what may be an arbitrary BMI cutoff and justify surgery at lower BMIs as part of metabolic therapy. Click here to learn more about the surgical options Dr. Christine Ren-Fielding offers through NYU Langone Weight Management Program.