New Data on Diabetes, Kidney Disease and Heart Attack Presented at American Society for Metabolic & Bariatric Surgery (ASMBS) Annual Meeting

Newswise — GAINESVILLE, FL – JUNE 13, 2012 – New data on metabolic and bariatric surgery and its effects on Type 2 diabetes remission, heart attack prevention and kidney disease will be presented by researchers from institutions including Stanford University, Cleveland Clinic and Duke University, at the 29th Annual Meeting of the American Society for Metabolic & Bariatric Surgery (ASMBS), being held at the San Diego Convention Center from June 17 to June 22, 2012. A Stanford University study showed dramatic reductions in the incidence of heart attack up to seven years after metabolic and bariatric surgery, and a Cleveland Clinic study showed a nearly 60 percent reduction in kidney disease and a 44 percent remission rate of Type 2 diabetes after five years, among obese diabetic patients. Other studies identify which surgical patients are most likely to experience diabetes remission, and the effect of race and gender on weight loss. Long-term studies on gastric sleeve, an increasingly popular procedure, and one of the largest studies on robotic-assisted gastric bypass, will also be presented. “The data provides new perspectives on the different mechanisms of action of metabolic and bariatric surgery and how effective they are in fighting and preventing the disease of severe obesity, and some of the biggest public health threats facing the world,” said Robin Blackstone, MD, President, ASMBS. “In the big picture, what these studies are telling us is obesity should be treated, and the sooner, the better.” Lessening the Risk of Heart Attack -- Stanford UniversityResearchers from Stanford University say their study is the first to demonstrate a long-term and sustained cardiac benefit for gastric bypass across 11 known risk factors. Individual risk factors including inflammation, high cholesterol and metabolic syndrome saw double-digit reductions seven years after surgery.

Avoiding Complications of Type 2 Diabetes -- Cleveland ClinicCleveland Clinic investigators found that nearly 60 percent of obese patients with diabetic nephropathy, the leading cause of end-stage kidney disease, no longer had the condition five years after surgery, and 75 percent avoided the complication entirely. These same investigators published a landmark study earlier this year in the New England Journal of Medicine showing bariatric surgery can put Type 2 diabetes into remission even before substantial weight loss occurs.

New Data On Sleeve Gastrectomy -- Cleveland Clinic Florida, Stanford University and Naval Medical CenterSeveral institutions report on the safety and effectiveness of sleeve gastrectomy, one of the newer and increasingly popular methods of metabolic and bariatric surgery. Researchers compared outcomes to more established procedures and found this option is as safe, or even safer, than gastric bypass and gastric banding for many patients. Though conducted individually, studies from Cleveland Clinic Florida, Stanford University and Naval Medical Center in San Diego combine to include data from more than 270,000 patients.

Race and Gender May Be Factors in Weight Loss -- Duke University and Einstein Health Care NetworkA Duke University study found that while race may have played a factor in weight loss among gastric bypass patients with no Type 2 diabetes, it played no role if they had the disease. Patients with diabetes lost just as much weight and experienced remission or improvement of the disease at about the same rate. In contrast, researchers from Einstein Health Care Network in Philadelphia, not only observed differences between African-Americans and Caucasians, they identified differences between men and women.

Not All Patients Experience Remission of Type 2 Diabetes -- University of Massachusetts Medical CenterResearch from the University of Massachusetts Medical Center in Worcester may show which severely obese patients with Type 2 diabetes achieve complete remission of the disease following bariatric surgery. Researchers found a patient's weight, before or after surgery, had no bearing on whether or not his or her diabetes went into remission. Factors including how long a patient had the disease before surgery and the kind of medication they were taking, on the other hand, were highly predictive of success in battling the disease that affects more than 20 million Americans.¹ About Obesity and Metabolic and Bariatric SurgeryObesity is one of the greatest public health and economic threats facing the United States.² Approximately 72 million Americans are obese³ and, according to the ASMBS, about 18 million have morbid obesity. Obese individuals with a BMI greater than 30 have a 50 to 100 percent increased risk of premature death compared to healthy weight individuals as well as an increased risk of developing more than 40 obesity-related diseases and conditions including Type 2 diabetes, heart disease and cancer.^4,5 The federal government estimated that in 2008, annual obesity-related health spending reached $147 billion,⁶ double what it was a decade ago, and projects spending to rise to $344 billion each year by 2018.⁷ Metabolic/bariatric surgery has been shown to be the most effective and long lasting treatment for morbid obesity and many related conditions and results in significant weight loss.^8,9,10 In the United States, about 200,000 adults have metabolic/bariatric surgery each year.¹¹ The Agency for Healthcare Research and Quality (AHRQ) reported significant improvements in the safety of metabolic/bariatric surgery due in large part to improved laparoscopic techniques.¹² The risk of death is about 0.1 percent¹³ and the overall likelihood of major complications is about 4 percent.¹⁴

About the ASMBS The ASMBS is the largest organization for bariatric surgeons in the world. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of morbid obesity, as well as the associated risks and benefits. It encourages its members to investigate and discover new advances in bariatric surgery, while maintaining a steady exchange of experiences and ideas that may lead to improved surgical outcomes for morbidly obese patients. For more information, visit www.asmbs.org.

REFERENCES

¹ National Health and Nutrition Examination Survey (1999 – 2002) – Centers for Disease Control and Prevention. (2007). Accessed March 2012 from http://asmbs.org/benefits-of-bariatric-surgery/

² Flegal, K. M., Carroll, M. D., Ogden, C. L., et al. (2002). Prevalence and trends in obesity among US adults, 1999-2000. Journal of the American Medical Association. 288(14) pp. 1723-1727 Accessed March 2012 from http://aspe.hhs.gov/health/prevention/

³ Chronic Disease Prevention and Health Promotion – Centers for Disease Control and Prevention. (2011). Obesity; halting the epidemic by making health easier at a glance 2011. Accessed February 2012 fromhttp://www.cdc.gov/chronicdisease/resources/publications/AAG/obesity.htm

⁴ Office of the Surgeon General – U.S. Department of Health and Human Services. Overweight and obesity: health consequences. Accessed March 2012 from http://www.surgeongeneral.gov/topics/obesity/calltoaction/fact_consequences.html

⁵ Kaplan, L. M. (2003). Body weight regulation and obesity. Journal of Gastrointestinal Surgery. 7(4) pp. 443-51. Doi:10.1016/S1091-255X(03)00047-7. Accessed March 2012 from http://edulife.com

⁶ Finkelstein, E. A., Trogdon, J. G., Cohen, J. W., et al. (2009). Annual medical spending attributable to obesity: payer- and service-specific estimates. Health Affairs. 28(5) w822-w831. Accessed February 2012 from http://www.cdc.gov/obesity/causes/economics.html

⁷ Thorpe, K (2009). The future costs of obesity: national and state estimates of the impact of obesity on direct health care expenses. America’s Health Rankings. Accessed June 2012 from http://www.fightchronicdisease.org/sites/fightchronicdisease.org/files/docs/CostofObesityReport-FINAL.pdf

⁸ Weiner, R. A. (2010). Indications and principles of metabolic surgery. U.S. National Library of Medicine. 81(4) pp.379-394.

⁹ Chikunguw, S., Patricia, W., Dodson, J. G., et al. (2009). Durable resolution of diabetes after roux-en-y gastric bypass associated with maintenance of weight loss. Surgery for Obesity and Related Diseases. 5(3) p. S1

¹⁰ Torquati, A., Wright, K., Melvin, W., et al. (2007). Effect of gastric bypass operation on framingham and actual risk of cardiovascular events in class II to III obesity. Journal of the American College of Surgeons. 204(5) pp. 776-782. Accessed March 2012 from http://www.ncbi.nlm.nih.gov/pubmed/17481482

¹¹ American Society for Metabolic & Bariatric Surgery. (2009). All estimates are based on surveys with ASMBS membership and bariatric surgery industry reports.

¹² Poirier, P., Cornier, M. A., Mazzone, T., et al. (2011). Bariatric surgery and cardiovascular risk factors. Circulation: Journal of the American Heart Association. 123 pp. 1-19. Accessed March 2012 from http://circ.ahajournals.org/content/123/15/1683.full.pdf

¹³ Agency for Healthcare Research and Quality (AHRQ). Statistical Brief #23. Bariatric Surgery Utilization and Outcomes in 1998 and 2004. Jan. 2007.

¹⁴ DR Flum et al. “Perioperative Safety in the Longitudinal Assessment of Bariatric Surgery.” New England Journal of Medicine. 2009. 361:445-454. http://content.nejm.org/cgi/content/full/361/5/445