Melbourne: A long-term study by Monash University researchers – the first of its kind – has found that gastric band surgery has significant benefits for moderately overweight people with type 2 diabetes. Previous studies have focused on obese people. 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.
with obesity, is occurring in epidemic proportions. According to
Diabetes Australia, an estimated 1.7 million Australians currently have
the disease. Nearly 90 per cent 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
It found an average weight loss of 12.2 per cent
of body weight in the gastric band group compared with 1.8 per cent in
the medical care-only group. Almost a quarter of the gastric band group
showed diabetes remission at five years, compared to nine per cent of
the medical care-only group.
“We had people who were feeling better, moving better and who were happier because of the surgery,” Dr Wentworth said.
“Their diabetes was better controlled and they needed fewer diabetic medications to control their blood sugar levels,” he said.
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.
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.
be delighted if people could lose over 10 per cent of their weight
through lifestyle modification, the reality is that the vast majority of
people can’t manage that.”
The study, conducted in Melbourne
between November 2009 and June 2016, found few adverse events associated
with the gastric banding – three patients had transient difficulty with
swallowing while two had gastric band revision surgery.
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.
the latest findings suggest that the minimum Body Mass Index (BMI) limit
for gastric band surgery be revised. Currently guidelines suggest the
surgery be reserved for people with a BMI of over 35, whereas those in
the study had a BMI of 25-30.
Published in Diabetes Care 2017;
40:e2, the paper is titled Trial of Gastric Band Surgery in Overweight
but Not Obese People With Type 2 Diabetes. Authors include Wentworth JM,
Burton P, Laurie C, Brown WA, O'Brien PE.