Bypassing Diabetes

: Rocco Turso was injecting himself with insulin three times a day, swallowing pills twice daily and restricting his diet. But his diabetes was still out of control, blurring his vision, making his feet numb and sapping his energy. So he decided to try an experimental operation. Within days, his blood sugar was normal and he was off all his medications.

“I use the word ‘miracle’,” said Turso, 62, from New York. “The diabetes was killing me. It’s given me back my life.”

Turso is one of a handful of Americans who have undergone a novel procedure that proponents say appears to offer the most important advance since the discovery of insulin in treating one of the most common chronic diseases.

“It’s extremely promising,” said Madhu Rangraj, chief of laparoscopic surgery at the Sound Shore Medical Center in New Rochelle, New York, who performed the operation bypassing part of Turso’s small intestine in March. “It’s a surgical solution to diabetes.”

While many surgeons share Rangraj’s enthusiasm, and some diabetes experts agree that the operation and similar ones may lead to fundamental new insights into the disease, others remain cautious. Much more research is needed, they say, to validate the effectiveness of the procedure. They worry that the operations will start to proliferate before their long-term safety and effectiveness have been proven, as often occurs with novel surgeries.

“I’m skeptical,” said R Paul Robertson, president-elect of the American Diabetes Association. “It bothers me to see this message being put out there that we can now cure diabetes through surgery. They have to prove that to me.”

Turso’s operation is a variation of a procedure developed to treat severe obesity. Known as bariatric surgery or gastric bypass, the standard operations reduce the size of the stomach and bypass part of the intestine. That limits the amount of food a person can eat and the calories that can be absorbed. The procedures have soared in popularity as the obesity epidemic has spread and clinical trials have validated their safety and effectiveness.

Although doctors have long known that losing weight can alleviate Type 2 diabetes, the most common form of the disease, they were surprised to discover that many patients saw their blood sugar return to normal remarkably quickly after the operations, often within days -- and before they had lost much weight.

“There’s something significant that’s happening as a result of this surgery that we haven’t yet identified,” said Neil Hutcher, a...

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