Curing Diabetes Via Surgery, Without Weight Loss

Not even close.

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. Then in 2009, the 45-year-old Connecticut wife, mother of two and head of human resources for a Fortune 500 company 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. 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. More remarkably, Iaboni no longer has diabetes.

She is not the first patient with diabetes to be cured by weight-loss surgery. But she is a rarity for having it with a BMI well below 35, 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.

Even the article admits she lost weight.

It does not say what "not much" equals.

Bariatric surgeons have long been prone to declaring victory against diabetes way too soon, before large-scale, long-term data proved their case. "The evidence for the success of bariatric surgery in patients with a BMI below 35 is not very strong," said Dr. Leonid Poretsky, director of the Friedman Diabetes Institute at Beth Israel Medical Center in New York City. "Most of the studies have been very small and not well controlled."

The American Diabetes Association rates the evidence that bariatric surgery can cure diabetes as "E," the lowest of four grades. It calls data on patients with a BMI below 35 "insufficient," and says the procedure cannot be recommended except as part of research.

Yup.