Dr. Ramsey Dallal has known for decades, as have other bariatric surgeons, that gastric bypass surgery can help patients control or cure their diabetes. Finally, this week, the world’s leading experts on diabetes acknowledged as much—a fact that may change the perception of gastric surgery as a last-ditch treatment for patients who may be too debilitated by then to benefit.
(Ramsey Dallal, MD, above, at right)
An international group of 45 diabetes specialists, researchers and organizations issued a game-changing guideline this week that diabetes patients be offered gastric surgery as a standard treatment option. It was noted as the most dramatic shift in diabetes treatment since the emergence of insulin.
"There is no treatment through medication that comes close to providing the benefits of an operation that can be done in one hour’s time, by laparoscopy, with an overnight hospital stay and provides a multitude of other benefits such as improvement in sleep apnea and a decreases in cancer rates."
—Ramsey Dallal, MD
Dr. Dallal, chair of the Department of Bariatric Surgery at Einstein Healthcare Network, was gratified by the acknowledgment, and hopes it will change the attitude of endocrinologists and family physicians who have been reluctant, despite the existing evidence, to recommend surgery for their diabetic patients.
“Gastric bypass surgery either cures or improves Type 2 diabetes at an astounding rate and improves patients’ life expectancies, quality of life, reduces their reliance on medication and the associated costs, and decreases the complications of diabetes such as heart disease, kidney disease and peripheral vascular disease,” Dr. Dallal said.
“There is no treatment through medication that comes close to providing the benefits of an operation that can be done in one hour’s time, by laparoscopy, with an overnight hospital stay and provides a multitude of other benefits such as improvement in sleep apnea and a decreases in cancer rates. And these have all been well established. “The perception that bariatric surgery is dangerous is also wrong, he said: it has the same complication rate as gallbladder surgery.
The international guidelines may result in diabetic patients receiving surgery much earlier in their disease, which is critical. The chances of reversing diabetes in patients who’ve had diabetes for longer than 10 years drops from 80 to 50 percent, Dr. Dallal said. “If they’ve had it for less than five years, it’s 95 percent. We’d like to see patients earlier when you can allow for permanent remission of diabetes instead of seeing patients who are often too sick and have diabetes for too long and require too many medications.”