MONDAY, Dec. 29 (HealthDay News) -- Obese teenagers who have gastric bypass surgery not only lose weight but see their type 2 diabetes disappear, a new study finds.

Also called bariatric surgery, the procedure works by limiting the size of the stomach and thereby reducing the amount of food one can eat. In this study, researchers used the Lapband method, which involves placing an adjustable band to block off most of the stomach. The band limits how much food the body absorbs.

"Previous studies have shown frequent remission of type 2 diabetes in adults following bariatric surgery, but until now, no research had been done to provide information about outcomes of adolescent diabetics who are considering surgical weight loss," said lead researcher Dr. Thomas H. Inge, an associate professor of surgery and pediatrics at Cincinnati Children's Hospital Medical Center.

"Our study found that, in most cases, teens can lose one-third of their weight and come off diabetes medications with remission of their diabetes one year after bypass surgery. This is certainly not the case for similar diabetic teenage patients who did not undergo surgery," Inge noted.

The report is published in the January issue of Pediatrics.

For the study, Inge's group looked at 78 teens with type 2 diabetes. Eleven patients underwent gastric bypass surgery, while the other 67 patients received usual care for their diabetes.

For the teens who had surgery, not only did they have an average 34 percent reduction in their weight, but their diabetes went into remission. Teens that did not have surgery saw an average weight loss of less than two pounds and still needed their diabetes medication.

"In addition to the impressive weight loss and type 2 diabetes results, patients undergoing the gastric bypass surgery also showed significant improvement in blood pressure, insulin, glucose, cholesterol and triglyceride levels," Inge said.

Type 2 diabetes takes a huge toll on the body, and the earlier it starts, the more of an impact it can have, Inge explained.

"These early surgical research findings suggest that diabetes may not be a diagnosis kids have to live with for the rest of their lives," Inge said. "They may not have to face diabetic retinopathy, progressive coronary heart disease and renal failure. In fact, there is good reason to be optimistic about their future cardiovascular health."

"If you are a type 2 diabetic and morbidly obese, gastric bypass surgery should be considered in the treatment pathway," Inge added.

Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine, thinks that while surgery is effective it does not deal with the cause of the obesity epidemic among teens.

"Bariatric surgery is clearly effective in treating severe obesity, preventing and reversing type 2 diabetes, and even extending survival when applied to adults," Katz said. "That similar benefits ensue when the procedure is applied to adolescents is important, but by no means surprising."

Despite the success of surgery, these results should be viewed with caution, Katz said.

"A large and growing proportion of all children and adolescents are subject to obesity, and its complications," Katz said. "Surgery can mitigate those complications, but can we really condone ushering more and more young people through the OR doors for a major surgical procedure to fix what policies and programs that foster healthful eating and regular activity could have prevented in the first place?"

Gastric bypass surgery is an effective last resort for severe obesity in adolescence, as in adulthood, Katz said. "But a last resort it should be, and we should do all we can to minimize the need for this procedure by combating the root causes of obesity in our society."

More information

For more on gastric bypass surgery, visit the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

MONDAY, Jan. 5 (HealthDay News) -- More and more people with diabetes are living to older ages, thanks to medical advances. But the long-term facilities, such as nursing homes, that care for aging Americans may not be ready for the additional challenges that come with treating patients with diabetes.

"We need to spend appropriate time to think of a way to successfully provide care for people with diabetes as they enter their elder years, and we're just beginning to understand how to do that," said Dr. Paul Strumph, vice president and chief medical officer for the Juvenile Diabetes Research Foundation.

Although as many as one in four nursing home residents has diabetes, not all are getting care that meets the American Diabetes Association's goals for community-dwelling adults, according to a recent study.

The study, published in Diabetes Care, found that while 98 percent of nursing home residents with diabetes had their blood glucose levels monitored, only 38 percent met short-term glucose goals.

The better news from the study was that 67 percent of the nursing home residents with diabetes met their long-term glucose control goals, which meant they scored less than 7 percent on their A1C tests. A1C is a measure of long-term blood sugar control.

"One of the key differences in managing diabetes in a nursing home is that it's often not the condition of primary importance," said Helaine Resnick, director of research at the Institute for the Future of Aging Services for the American Association of Homes and Services for the Aging.

Resnick said one of the concerns she had with the study findings was that no one has yet to come up with specific guidelines for caring for elderly people with diabetes. Glucose control goals for someone who's 40 and living at home may well be different than for someone who's 85, cognitively impaired, and living in a long-term care facility, she said.

"Diabetes medications are designed to lower glucose levels, which can prevent complications from developing in diabetic people. But, when you take medicines to lower blood glucose, it can go too low, which can be extremely dangerous, especially for older adults," Resnick said, noting that it's difficult to find "the appropriate balance between keeping sugars low with the risk of keeping it too low."

Strumph pointed out that the needs of older people with diabetes may be different as well. People with type 1 diabetes and people with type 2 diabetes who need insulin often choose to use an insulin pump when they're younger, but pumps may not be the best choice for someone who's older and not as aware, he said.

"Someone in a nursing home could pull out a pump site and not know. In that case, you may want to be on a longer-acting insulin instead. We haven't yet defined what the ideal insulin [regimen] is for someone in a facility with a fairly predictable schedule," Strumph said.

Both Strumph and Resnick said it's important for family members, the nursing home resident, and the staff to come up with a realistic care plan.

"Families need to become more actively involved in working with care teams, and that's true for diabetes and for other conditions. Ensure that the facility understands the family's and the resident's preferences. Is your mother more interested in keeping her blood glucose control tight and risk [low blood sugar]? Or is it better for her to ease up on glucose control and work more on quality-of-life issues? Resnick said.

"Families have to be very involved, and the communication needs to be ongoing, because people's values can change," she added.

More information

For tips on selecting a nursing home, visit the AARP Web site  .