The PR people from the Cleveland Clinic sent me a fact sheet about the study that was all over the news yesterday, which is being headlined as if Weight Loss Surgery was a cure for diabetes.
The facts presented in the sheet were slightly different and more informative than the summary presented in the New England Journal of Medicine research report.
Here's the research report: NEJM: Bariatric Surgery versus Intensive Medical Therapy in Obese Patients with Diabetes.
Here are extracts from the press release sent to me by the Cleveland Clinic's PR team. 150 patients participated in a 1 year-long trial. 50 had gastric bypass surgery, 50 had gastric banding, and 50 got the usual crap treatment from doctors including, undoubtedly, the advice to eat low fat/high carb diets. Here's what they report.
"After 12 months, a normal HbA1c (less than 6.0) was achieved in 42.6 percent of patients who underwent gastric bypass and 36.7 percent of patients who underwent sleeve surgery..."
Translation, 56.4% of those who had chunks of their stomachs amputated still ended up with blood sugar far from "cured" or even normal. The NEJM report says the average A1c for those having bypass was 6.4±0.9% that means, many still had A1cs up to 7.3%.
Those with gastric banding did even more poorly. 63.3% of them had A1cs over 6.0% The NEJM report says that their Average A1c was 6.6±1.0%, meaning that some still had A1cs of 7.6%.
Many of us can get A1cs under 6.0% just by cutting carbs. I have heard from hundreds of people, some of whom started out with A1cs well over 10.0% who did just that.
The study continues:
"The study authors reported some complications of surgery, but most were not serious. However, four patients did require a second operation. The study authors caution that the favorable results were observed after a relatively short follow-up period (12 months) and that long-term studies are needed to determine the durability of the findings."
Translation: 4 out of 100 people who had surgery ended up with a "complication" like their incisions opening internally that required them to be rushed to the hospital. The rest of the complications aren't detailed, but while not disturbing to the doctors, they may have been tough on the patients. Some complications of WLS can be projectile vomiting whenever people eat, severe mineral deficiencies caused by malabsorption syndrome, and surgical site infections that heal poorly.
It's important to note that this study only lasted 1 year and that previous studies of WLS find that the participants uncure themselves pretty quickly as time goes by. I blogged about earlier results claiming similar cure rates. You can read that post HERE.
This study reports, "There were no deaths." The current kill rate for this surgery ranges from 1 to 6 per thousand, so with only 100 people having the surgery, the fact that no one died doesn't mean its safe. If the kill rate is 1 per thousand and 150,000 people have the surgery, that's 150 people dead.
You can see the death rates for the surgery on this surgeon-created site. Bariatric Surgery Source: Gastric Bypass Surgery Deaths Note that surgeons only list the deaths that happen immediately after the surgery. Not those that occur from malnutrition and other longer-term surgically-caused problems.
To read more about the actual death rate associated with WLS when people are tracked more than 1 year, read the post I made two years ago HERE..
WHAT WASN'T MENTIONED IN THE COVERAGE
Here's the kicker, which appeared at the bottom of the press release: "This study was funded by Ethicon Endo-Surgery, Inc., a subsidiary of Johnson & Johnson, which is a company that designs and manufactures medical devices and surgical instruments. Dr. Schauer is a paid advisory board member of Ethicon, and is in complete compliance with all Cleveland Clinic COI policies."
Dr. Shauer is the first author listed on the NEJM paper. The disclosure, which didn't make it into any of the press coverage, makes it clear that he profits from the sale of the devices used for these weight loss surgeries. This is not research folks, this is a business promotion.
Do you really want to risk your life for a surgery that would give you results no better than you could get by getting serious about cutting down on your carbs? The same people who warn you it is "dangerous" to lower your A1c by cutting your carbs urge you to have this potentially fatal surgery to "cure" your diabetes. Shame on them!
If that's a cure, I'll stick to the disease. My A1cs have been far better than that for longer than 5 years, and so have those of many of you. (Post them in the comment section if you're inclined to.)
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