NEW YORK, (Reuters) – Cristina Iaboni had the dubious distinction of being not quite obese enough. For all the pounds on her 5’5” frame, she did not meet the criteria for bariatric surgery to help control her type-2 diabetes.
Yet six years of medications and attempts at healthy living had failed to rein in her blood glucose, leaving Iaboni terrified that she was on course to have her kidneys fail “and my feet cut off” — common consequences of uncontrolled diabetes.
Then the 45-year-old Connecticut wife, mother of two and head of human resources for a Fortune 500 company, lucked out. In 2009 she met with Dr Francisco Rubino of Weill Cornell Medical Center in New York. He had just received approval to study experimental surgery on diabetics with a relatively lean weight-to-height ratio, or body-mass index (BMI). Iaboni was among his first subjects.
Three years on, she has dropped 50 pounds to reach a healthy 145 and has normal blood pressure without medication. That isn’t too surprising: Weight loss is the purpose of bariatric surgery and often reduces blood pressure. More remarkable, Iaboni no longer has diabetes.
She is not the first patient with diabetes, which can be triggered by obesity, to be cured by weight-loss surgery. But she is a rarity for having it with a BMI well below 35 and over. That’s the level at which the American Diabetes Association says surgery “may be considered” and that Medicare and some private insurers cover. And Iaboni’s diabetes disappeared months before she shed much weight.
Her experience has raised an intriguing possibility: that some forms of bariatric surgery treat diabetes not by making patients shed pounds. Instead, by rerouting part of the digestive system, they change what signals the gut sends to the brain and the brain sends to the liver, altering the underlying causes of diabetes.
If proven, bariatric surgery may help people with type-2 diabetes who are less obese, overweight or even of healthy weight. And it might be effective against the currently incurable type-1, or “juvenile,” diabetes, too.
“Every textbook says that diabetes is chronic, irreversible, and progressive,” said Rubino. “But we have thousands of patients who once had diabetes and now do not.”
