Gastric Surgery for Diabetes

Type 2 diabetes is a complex condition that we are only beginning to understand, type 1 diabetes is an autoimmune disease, and type 1.5 is a new condition that we are beginning to study. Nevertheless, the media has latched on to two new medical studies and named gastric bypass surgery the new diabetes cure for type 2 diabetes.

I understand that people want quick solutions. I also know that one's relationship with their weight and stomach is complex. But your stomach is not just part of your "beauty" or "physique" nor is it just about digestion. Your stomach is the home for the many good microbes you need that help control your endocrine and immune systems.

Keep in mind that your body has 10 trillion cells and 100 trillion microbes that all work to keep you healthy. How exactly these microbes work is part of an evolving science. Some good information on the microbiome was provided in a recent Wired magazine. You can also learn about the brain in your gut by viewing the TED presentation by Heribert Watzke: The brain in your gut.

So anyone who encourages the cutting out of parts of the stomach as the answer does not understand the relationship between the stomach and health. The surgeons who advocate cutting do not address what happens to your microbiome, i.e., the healthy bacteria in your gut, that we are now learning are so important to our endocrine and immune systems.

Gastric surgery is not the answer.

And for this we have government?

The October 6, 2008 USA Today article “Sleuths go door to door to sniff out Medicare fraud” is a good example of how we can go so very wrong with how we focus on reducing costs. I do not know what other people read but for me it was a waste of government dollars to send out the sleuths. What did they discover? That an 86 year old man was able to go on walks and therefore was not eligible to get the home health care costs of having a nurse go to the house to give him his injection. Sounds odd?

While we all celebrate that the man could take a walk; walking involves being able to move your feet while injecting yourself involves your hands. It seems that Medicare only pays for the nurse to go to the home if the person is homebound. The sleuth who discovered the man commented that the man’s nervousness about giving himself an injection was not sufficient reason to qualify him for the nurse visit. Is it reasonable to expect that every 86 year old person should be able to inject themselves? Did anyone take into account the savings that Medicare accrued since the man was able to live at home because he had this help? Moreover, the reporter confused the work of the nurse and that of the health aide.

While the sleuth may have been using the Medicare standard; it is obvious that the standard has to change. We need to have more sanity in how we care for each individual. Blanket rules such as this do more damage than good— rather than cover they suffocate.