Observational studies suggest that surgically induced loss of weight may be effective therapy for type 2 diabetes.
Dr John Dixon and colleagues from Australia determined if surgically induced weight loss results in better glycemic control.
The research team also investigated whether it resulted in a reduced need for diabetes medications than conventional approaches to weight loss and diabetes control.
|Remission of type 2 diabetes was achieved by 73% in the surgical group|
|Journal of the American Medical Association|
The team conducted an unblinded randomized controlled trial from between 2002 through 2006 at the University Obesity Research Center in Australia.
The research team also conducted general community recruitment to established treatment programs.
Participants were 60 obese patients with recently diagnosed type 2 diabetes.
Conventional diabetes therapy with a focus on weight loss by lifestyle change was compared with laparoscopic adjustable gastric banding with conventional diabetes care.
Remission of type 2 diabetes was measured by fasting glucose levels less than 126 mg/dL, glycated hemoglobin value less than 6% while taking no glycemic therapy.
The team's secondary measures included weight and components of the metabolic syndrome.
Analysis was by intention-to-treat.
The researchers found that of the 60 patients enrolled, 92% completed the 2-year follow-up.
Remission of type 2 diabetes was achieved by 73% in the surgical group and 13% in the conventional-therapy group.
The researchers found that the relative risk of remission for the surgical group was 5.5.
Surgical and conventional-therapy groups lost a mean of 21% and 5% of weight, respectively, at 2 years.
Remission of type 2 diabetes was related to weight loss and lower baseline glycated hemoglobin levels.
The team found no serious complications in either group.
Dr Dixon's team concluded, "Participants randomized to surgical therapy were more likely to achieve remission of type 2 diabetes through greater weight loss."
"These results need to be confirmed in a larger, more diverse population and have long-term efficacy assessed."