Diabetes Self-Management Blog

Gastric banding can be an important tool for treating Type 2 diabetes in people who are overweight but not obese, according to researchers from Monash University in Australia. Over 1 million Australians, and an estimated 26 million Americans, are living with Type 2 diabetes.

Bariatric surgery — in which parts of the stomach and small intestine are surgically altered or removed to reduce how much can be eaten or absorbed, causing weight loss — has been shown to improve diabetes in people who are obese (defined as a body-mass index of 30 or more), but the effect on blood glucose in people who are overweight (a body-mass index of 25–29.9) has not been clearly established.

To determine the impact of gastric banding (a type of bariatric surgery in which a band is placed around the stomach via a small incision to limit how much can be eaten at any one time) on blood glucose control, the researchers looked at 50 overweight Australians with Type 2 diabetes. All of the participants received diabetes care based on guidelines from the American Diabetes Association, including calorie-restricted diets tailored by a dietitian, 150 minutes of moderate-intensity exercise each week, treatment with various diabetes medicines, and meetings with a diabetes educator. Half of the group was also randomly assigned to undergo gastric banding within three months of the start of the trial. The surgery was performed as an outpatient procedure and, according to the study authors, had no significant adverse effects.

Two years into the trial, average weight loss was roughly 25 pounds in the banding group, with 52% of those who’d received the procedure experiencing a remission of their diabetes. Among those who did not have the banding surgery, the average weight loss was about 3.5 pounds, and 8% of the participants were in remission.

“This is the first randomized controlled trial demonstrating that treatment of Type 2 diabetes in overweight people by substantial weight loss is safe and hugely beneficial. As there are no alternative options that can achieve such a result, this study indicates a potentially attractive path for the overweight person with diabetes and for those providing the care” said study author Paul E. O’Brien, MD.

However, according to Greg Johnson, chief executive of Diabetes Australia, the study was too small to show that gastric banding could safely be used to treat Type 2 in people who are overweight. Instead, he recommends that they consider diet and lifestyle changes before surgery, which carries risks.

For more information, read the article “New ammunition in fight against type 2 diabetes” or see the study’s abstract in the journal The Lancet Diabetes & Endocrinology. And to learn more about possible approaches for “reversing” Type 2 diabetes, see this recent article by nurse David Spero.

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