Lowcarbarama is a gathering place for links and pointers to all sort of things relevant to low-carb: articles, blogs, interviews, Web sites, forums. It's a place for commentary on health and nutrition in public policy, the sciences and the media. Comments are welcome anytime, regardless of the post's date.

Friday, January 25, 2008

Hacking blindly at a problem

"'It's the best therapy for diabetes that we have today, and it's very low risk,' said the study's lead author, Dr. John Dixon of Monash University Medical School in Melbourne, Australia."

Sounds fantastic! Is Dr. Dixon speaking of restricting carbohydrates in the diet, so as to not flood the bloodstream with the glucose that a diabetic person's metabolism is ill-equipped to handle? So that person doesn't need to rely on insulin injections to normalize blood sugar, with side effects like obesity from the insulin moving the excess into fat cell storage?

Alas, no.

According to the lead author of a study published in JAMA Vol. 299 No. 3, January 23, 2008, as quoted in an AP release, the "best therapy for diabetes that we have today" is not cutting sugar and starch from the diet. It's bariatric surgery. Cutting down the size of the tummy. That's correct. There are doctors who believe that surgery -- gastric bypass, lap band surgery and the like -- with its risk of complication and morbidity, is a low-risk endeavor. Where's the risk in cutting sugar, wheat, potatoes, rice and other starches from the diet first? The foods that were absent from the diets of some of the healthiest groups of humans known to history, even into the twentieth century? (And perhaps also today, if groups like the Masai are still living their traditional lifestyle.)

Ironically, these are among the foodstuffs that are prohibited during the recovery period after these surgeries. In the AP/Yahoo article, Dr. David Cummings of the University of Washington in Seattle says that patients' diabetes often goes into remission shortly after the surgery, sometimes within only days. I wonder what would be the results in a control group of patients who adopted the post-surgery recovery diet, but who didn't actually have the surgery?

That is, is the miraculous remission from diabetes from the surgery? Or from the elimination of glucose from the bloodstream?

In the article, the assumption among the doctors seems to be that the positive effects in the diabetic condition result from the weight lost. Impossible. No significant amount of weight can be lost within several days. So what's the diabetes miracle? The fact that weight will be lost, now that the stomach is smaller? That would be a farfetched hypothesis.

A simpler one would be: something in the post-operative period itself relieves diabetes. The objective scientific mind would inquire as to what that is.

The quote that opens this post is appeared on Yahoo! News, dated Jan 24, 2008, here:
Obesity surgery seen as diabetes cure

Many more articles on this topic can be found through an Internet search for a set of terms like "diabetes obesity surgery JAMA."

Gastrointestinal Surgery as a Treatment for Diabetes
David E. Cummings and David R. Flum
JAMA. 2008;299(3):341-343.

Here's a link to JAMA's extract of the full article:

Full text is available to site members only. A trial site registration is offered at the link above.


Tracy said...

Just when you think they can't get any more ridiculous - they do. Why can't they see it?

Low Carb Band-It said...

As a lapband patient that follows a LC lifestyle. Please remember that a lapband is FAR different in risks and problems than a gastric bypass. Most people don't know this and just lump all weight loss surgery together. I'm not even saying it should be a first course of treatment for diabetes.

I'm not saying everyone shouldn't try a low-carb diet as well, but some people truly have a saity defect where the hunger mechanism doesn't work correctly and this gives them a bit more control over that issue. :o)