Gastric Band Surgery in Overweight Diabetics Reduces Health Risks

Highlights

• Nearly 90% of people with type 2 diabetes are overweight or obese in Australia.
• Bariatric surgery improves the patients' chances of diabetes remission, and reduced the need for diabetes medication.
• Those who underwent a gastric bypass had an average weight loss of 12.2% compared with 1.8 percent in those who were on medications.
• The study suggest that the surgery could be done for those with a BMI of 25-30 instead of those over 35.

Gastric band surgery has significant benefits for moderately overweight people with type 2 diabetes, according to a long-term study by Monash University researchers. The five-year study by Monash's Centre for Obesity Research and Education (CORE), found that gastric or Lap-band surgery improved the patients' chances of diabetes remission, reduced the need for diabetes medication and dramatically enhanced their quality of life.

According to Diabetes Australia, an estimated 1.7 million Australians currently have the disease. Nearly 90 percent of people with type 2 diabetes are overweight or obese.

The study, led by clinician researcher Dr John Wentworth and weight loss surgeon Professor Paul O'Brien, compared 45 participants: 22 randomised to receive gastric banding combined with medical care, and 23 who received medical care alone. Both groups received help with lifestyle factors such as exercise and healthy eating.

The average weight loss in the gastric band group was 12.2% compared with 1.8 percent in the medical care-only group. Almost a quarter of the gastric band group showed diabetes remission at five years, compared to 9% of the medical care-only group.

"We had people who were feeling better, moving better and who were happier because of the surgery. Their diabetes was better controlled and they needed fewer diabetic medications to control their blood sugar levels," Dr Wentworth said.

Dr Wentworth said the study provided "reasonably strong evidence" that gastric banding, as a safe and effective weight loss operation, was an acceptable alternative for people who wanted it.

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"It's an important point because Lap banding is criticised by some people saying it is far too drastic to be used as a diabetes treatment and that it doesn't work in the longer term," he said.

"I think it's a matter of just looking at the best ways of managing diabetes and preventing diabetes complications. We're interested in making life easier for these people and reducing the risk of the main complications, mainly heart attack, kidney failure, blindness and amputation.

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"Although we'd be delighted if people could lose over 10% of their weight through lifestyle modification, the reality is that the vast majority of people can't manage that."

The study found few adverse events associated with the gastric banding - three patients had transient difficulty with swallowing while two had gastric band revision surgery.

The gastric band surgery and after-care cost an average AUD$13,910, countered partly by a saving of AUD$4,257 on drug therapy. Dr Wentworth said that long-term improvements in quality of life further offset the cost of surgery: the wellbeing gained after surgery was similar in magnitude to that gained from knee replacement surgery.

Reference

1. John M. Wentworth et al., Five-Year Outcomes of a Randomized Trial of Gastric band Surgery in Overweight but Not Obese People With Type 2 Diabetes, Diabetes Care (2017) http://dx.doi.org/10.2337/dc16-2149.

Source-Medindia