Diabetes Self-Management Blog

A study published in January in The Journal of the American Medical Association found that gastric banding weight-loss surgery in obese people with Type 2 diabetes led to better blood glucose control and higher rates of diabetes reversal than lifestyle changes meant to help people lose weight. The surgery also helped people lose significantly more weight than lifestyle changes. This was the first randomized study comparing weight-loss surgery to conventional therapy for managing Type 2 diabetes in obese people.

For the study, researchers recruited 60 participants who had recently been diagnosed with Type 2 diabetes (in the last two years). Their body-mass indexes were between 30 and 40, putting them in the obese (but not morbidly obese) category. The participants were randomly assigned to two groups: One group received conventional diabetes care, emphasizing lifestyle changes (diet and exercise) to help them lose weight, while the other group received conventional diabetes care and laparoscopic adjustable gastric banding surgery.

This type of surgery places an adjustable ring around the upper part of the stomach, creating a new, smaller pouch that can hold less food. This decreases the amount of food that can be eaten at once and slows the passage of food through the stomach, causing a prolonged sense of fullness.

The researchers wanted to see whether weight loss that resulted from the surgery would improve blood glucose control and lessen the need for diabetes drugs more than a traditional approach to Type 2 diabetes treatment.

Fifty-five of the participants completed the study. After two years, 73% of the people who had had gastric banding surgery had reversal, or remission, of diabetes compared to 13% of those in the lifestyle change group. (Remission of diabetes was defined as a fasting blood glucose level of less than 126 mg/dl and an HbA1c level of less than 6.2% without the help of blood-glucose-lowering therapy.) Also, members of the surgery group lost an average of 20% of their body weight, compared to an average loss of 1.7% of body weight in the lifestyle change group.

In both groups, a larger percentage of weight loss and a lower starting HbA1c level were associated with a higher chance of diabetes remission, with percentage weight loss having more of an effect.

The researchers commented that this study “presents strong evidence to support the early consideration of surgically induced loss of weight in the treatment of obsese patients with type 2 diabetes,” but also pointed out that its results need to be confirmed in larger, longer-term studies. What’s more, they concluded that the degree of weight loss, rather than the method by which it came about, was the most important factor for lowering blood glucose levels and reversing diabetes. People who lost more than 10% of their body weight—whether from surgery or from lifestyle changes—had a greater chance of reversing their diabetes.

The study took place at Monash University in Melbourne, Australia, and was funded by an unrestricted grant from Allergan Health, a company that manufactures laparoscopic adjustable gastric bands.

To learn more about weight-loss surgery and diabetes, please read the article “Bariatric Surgery: An Option for Long-Term Weight Loss.”

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Comments
  1. I was planning to write about this, too. Gastric banding is much less dangerous, less expensive, and easier to heal from than the old gastric bypass surgeries. I think it’s worth considering.

    I’ve long felt that it’s too bad that people have to mutilate their bodies to stay healthy. But the fact is that our food environment is so unhealthy that a banded stomach may be better for lot of us.

    David

    Posted by David Spero RN |
  2. Is there any downside ? and if not too severe. Where in the USA canyou have this done?

    Posted by CalgaryDiabetic |
  3. For some reason I hate the word reversal when speaking about Diabetes. It sounds like the word cure when we all know there is no “cure” for diabetes. If we are using the word control I would be much more inclined to agree with that assessment. Also just because a person is not on diabetes meds does not mean they do not have diabetes any longer.

    Posted by deafmack |
  4. This hits very close to home. I have lost a large amount of weight in a relatively short time frame. My glucose readings are very low now. Normal range some might say. I have eaten poorly at times (high carbs) to experiment and pretty much no glucose change. We’ll see how this progresses as I am pretty skeptical of such things.

    Posted by Philbur |
  5. I have Type II and was diagnosed 12 years ago. It is advancing quickly at this point and I do not have health insurance. Medicare, “fat” chance. does anyone know the cost of this surgery? I have severe nerve damage and bad knees which makes walking impossible and know I need to lose over 50 lbs. Exercize is difficult. Please let me know and thanks

    Posted by Oldgoat |
  6. Is there any evidence on if a person has crohn’s disease does this surgery affect the person in a negative wat? I’m thinking about having this done but I have crohn’s. I don’t want to do something that will have a bad result with the crohn’s

    Posted by Jean |
  7. If you google gastric banding or lap band, you should get directed to some websites that have lots of info. I do not think that they allow postings of websites, or I would put it here. I know of a couple of people who have had it done & were very pleased with the results.

    Posted by Trish |
  8. I’ve had the surgery done andvery satisfied withtheresults. You need to be determined andbe prepared to fight with your insurance cmpany and yes! AsfarasIknow medicare does cover the cost, but theymay refer you to having the lapband surgery. Be sure toget a good surgeon and into asupport group. Its not a cure all and you have to make different life style changes!

    Posted by wryjellybean |
  9. I’ve come across a site related to gastric banding that I thought could provide useful information. Gastric Band Surgery

    Posted by lizzieb |
  10. My type 2 diabetes is out of control. How or where can I sign up to be considered as part of the test group?

    Posted by pguccini |
  11. Hi pguccini,

    This study is already completed and took place in Australia. If you’re interested in the procedure, the first step would be to speak to your health-care provider to see if you would be a good candidate and if your insurance would cover the procedure.

    Posted by Tara Dairman, Web Editor |
  12. I am overweight and my doctor says that there is a surgery that will bypass my small bowels and will elminate the fat from absouring into my system. Is there a surgery like that? What would the surgery be called? And do I still go to a bariatic surgeon? I have Dercum’s Disease and I am at the point where it’s a matter of life and death!!!

    Posted by TruthBeKnown |
  13. Hi TruthBeKnown,
    There are many different gastric surgeries for weight loss, including the gastric band.
    A lapband only reduces the size of the stomach, but bypass surgeries remove portions of the intestines. Some of these surgeries are reversable, some are not. Some will cause mal-absorption, most will greatly aid with glucose control. Roux n Y is the most common bypass surgery, but gastric sleeves and a duodenal switch are also gaining popularity.
    Please spend time researching these procedures before you visit a bariatric surgeon as all of these procedures can have serious complications and side effects. They are also very effective for weight loss.
    I would also urge you to seek out a dietitian who specializes in working with gastric surgical patients, before and after a surgery.
    I hope this helps, best of luck.
    Laurie, Diabetes and Bariatric dietitian

    Posted by Laurie Kutrich, RD |

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