Diabetes Dramatically Improved-Pat Dittilo Shares in an Email

I received this Email from Pat Dittilo last week and she has agreed to share this with all of my readers. She said would like to encourage as many as possible. Here is what she shared:

Dr. Myers,

Hope you are doing well in your new position. I wanted to give you an update on my status since you and I have talked several times about the surgery and diabetes. I had a robot assisted gastric bypass by you in October of 2010, about 18 months ago. I was your 13th or 14th robotic case. I had type 2 diabetes diagnosed about 5 years before my operation and was on oral medicine as well as 10 micrograms of Byetta that I had to inject three times a day in addition to injecting 105 units of long acting insulin twice a day.

You may remember that my diabetes was out of control – my A1C was 11.7 and while I haven’t had it tested recently, my last A1C was 7.1 six months ago, (i will be having it checked again soon). I wanted to let you know that my sugar level yesterday and today were 94 and 89 and I am not taking any diabetic medication. I am so pleased and happy about my decision to have the surgery and even more pleased that you were here to do that for me. I have maintained my weight at 138 for over a year and I feel awesome. In addition to not taking any medication for my diabetes, I also no longer take medication for my blood pressure like I was before and my sleep apnea is completely gone. I’m 55 (almost 56) and I feel like a kid again. I have more confidence than I’ve ever had in my life.

It’s funny that so many people are more aware of the results of the surgery for those who have diabetes and the media attention it’s getting. Almost weekly I see something in the news about how people with diabetes are no longer dependant on insulin or completely cured. I can’t tell you how wonderful it is to wake up every day and not think about having to take those shots. I can eat without worrying about injecting the Byetta 30-60 minutes before I eat and how it made me sick to my stomach sometimes.

Thank you again for everything you did for me – I never thought I would feel so good again. Living my life without drugs and machines is a blessing, not to mention going from a size 18-20 to an 8-10!

God Bless you and your family. You are truly an Angel in many people’s lives.

Pat Dattilo

Diabetes is Treated Better with Surgery plus Medical Management than Medical Management Alone

Many of you may have read or heard about an important study published in the New England Medical Journal on March 26, 2012. Dr. Phil Schaur and his colleagues at the Cleveland Clinic completed a trial that has very profound implications for patients with Type 2 diabetes.

They compared 50 poorly controlled diabetic patients who had intensive medical management of their diabetes to 50 patients treated with a laparoscopic gastric bypass plus medical therapy and another 50 patients who were treated with a laparoscopic gastric sleeve plus medical therapy.

There was no mortality and complications were low.

The primary finding was that at the end of 1 year the patients who had surgery plus medical therapy achieved much better control of their diabetes. In fact, nearly 4 times as many patients in the surgery plus medical therapy group achieved excellent diabetic control than the group receiving only intensive medical therapy.

Between the two surgical options, the laparoscopic gastric bypass patients did somewhat better than the laparoscopic gastric sleeve patients.

Another important finding was that those receiving only intensive medical therapy increased the number of medicines they had to take over the year while those who had surgery plus medical therapy decreased the number of diabetic medicines and often were on no diabetic medicines at all.

Although it will be helpful to continue to follow these patients for several more years to evaluate the long term effects of better control, it is very clear that patients with type 2 diabetes do better if they have bariatric surgery than those who do not choose to have surgery.

Several months ago I mentioned that the medical establishment was too slow in accepting the remarkable improvement in diabetes after bariatric surgery. Could there be a sea change coming with this and other studies?

Why Robotic Bariatric Surgery?

Using a robot to perform a Roux en-Y gastric bypass brings significant value to patients.

I had performed at least 800 gastric bypass operations laparocopically without q robot before I began to perform this operation with the help of a surgical robot. The robot does not perform the operation but helps me perform the operation with more precision and with allowing me to see better.

I compared the last 100 gastric bypass operations I performed without a robot to the first 100 gastric bypass operations I performed with a robot. I found the following:

1). It took more time to perform the robotic operations. On one hand this is not surprising since I had performed so many laparoscopically and had the opportunity to decrease the time it takes me to perform the operation in that way. On the other hand it will take time for me to continue to to improve on the time.

2). Most patients in the robotic group left the hospital the day after the operation while most of the patients that had a gastric bypass operation without the use of the robot left the hospital after 2 days.

3). The patients in the robotic group had less bleeding. in fact only one patient in the robotic group received even 1 unit of blood whereas 5 patients in the non-robotic group received blood and they each received an average of more that 2 units of blood. I believe this is because I can see better, perform the operation with more precision and with the help of the robot I am able to perform some of the connections with sutures instead of staples.

4). There was no increase in complications with using the robot even though these were my first 100 operations.

Although it took a lot of patience and effort to learn to perform a gastric bypass with the surgical robot, I believe it was more than worth it.

Today most gastric bypass operations are performed laparoscopically without a robot. There is nothing wrong with having an operation in this manner and in fact this would be the choice for most surgeons. However, the robotic approach is being used by more surgeons and in my practice I have shown that I have even less complications when I use the robot.

If you have questions please let know and I will be happy to do my best to answer them.