Stomach Surgery for Type 2 Diabetes

Many patients with type 2 diabetes are obese, and are urged to lose weight as part of their treatment. An Australian study just published in the Journal of the American Medical Association offers a new way to achieve relevant results. It involved gastric banding surgery, a common type of surgery for obese individuals. What was interesting about this study was the dramatic effect on diabetes in many of the patients.

Sixty obese patients (body mass index between 30 and 40) with recently diagnosed type 2 diabetes (within the previous year) were randomly allocated to have conventional diabetes treatment or conventional care plus laparoscopic adjustable gastric banding surgery. The primary outcome to be measured was remission of diabetes, defined as a fasting blood glucose levels below 126 mg/dL and an HbA1c below 6.2% when not taking any antidiabetic medication.

At the 2-year follow-up point 73% of the surgery patients had remission of their diabetes, compare with13% of the conventional treatment group. The average weight loss with surgery was 20.7% vs. 1.7% without surgery. And analysis showed that individual weight loss was closely linked with remission of diabetes. There were no serious complications in either group of patients.

The doctors running the study emphasize that the degree of weight loss, not the method of achieving it, is the major driver of improvement in the subjects’ diabetes. “This suggests that intensive weight loss therapy may be a more important first step in the management of diabetes than simple lifestyle changes”. And if losing weight works for obese diabetics, it certainly can’t hurt merely overweight diabetics.