LOS ANGELES – For nearly a decade, Cristina Iaboni tried to tame her diabetes the usual way, through daily shots of insulin and other medicine.

Still, her blood sugar raged out of control. So Iaboni combed the Internet for another solution and found a doctor who is testing weight loss surgery on diabetics who, like herself, are merely overweight or a tad obese in an attempt to curb the chronic disease.

Scientists in recent years have discovered that diabetes all but disappears in some obese patients soon after the operation. Many were able to achieve normal blood sugar and ditch their medications.

But does the benefit extend to diabetics who are not quite as hefty? Performing surgery on the not-as-obese with the goal of reversing diabetes is provocative. Iaboni’s surgeon is one of a handful of doctors around the world stretching the rules to see if the weight loss operation helps.

Iaboni had gastric bypass surgery last fall at New York-Presbyterian/Weill Cornell Medical Center as part of a study. In gastric bypass or stomach stapling surgery, the stomach is reduced to a thumb-sized pouch that holds less food.

Now 50 pounds lighter, she has stopped taking diabetes medications. Her blood sugar is almost normal.

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“I didn’t care if I lost any weight. I just wanted the diabetes to go away,” said the 45-year-old Connecticut mother of two teenagers.

The twin epidemics of obesity and diabetes are fueling an international public health threat. In the United States, one out of five people with obesity-linked Type 2 diabetes are morbidly obese — 100 pounds overweight.

Surgery is generally a last resort after traditional ways to shed the pounds — such as diet and exercise — fail. Even so, there are strict rules for who can go under the knife.

Federal guidelines say surgery candidates must be morbidly obese with a body mass index over 40, or a BMI over 35 plus a weight-related medical problem like diabetes or high blood pressure. Insurers use the cutoffs in deciding whether to pay for the procedure.

BMI is a calculation of height and weight used to estimate body fat. Overweight begins at a measurement of 25, obese at 30 and morbidly obese at 40. A 5-foot-6 person is considered overweight at 155 pounds, obese at 186 pounds and morbidly obese at 248 pounds.

 


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