The authors of this Australian study had previously reported 2-year outcomes of a randomised trial of laparoscopic adjustable gastric band (GB) surgery in overweight but not obese people with type 2 diabetes. Diabetes remission was observed in 52% of the GB participants.
The investigators followed 45 of the original participants to 5 years; 22 were randomised to receive GB combined with medical care and 23 to medical care alone (MED).
The average weight loss was 12.2% in GB and 1.8% in MED participants. Diabetes remission was seen in five (23%) GB and two (9%) MED participants. Furthermore, those who had undergone GB used fewer anti-diabetes drugs and their averaged HbA1c level over 5 years was 10.4 mmol/mol (0.95%) lower than for the MED group.
Although blood pressure did not differ significantly between groups, mean HDL-cholesterol was 0.24 mmol/L higher and triglycerides 0.7 mmol/L lower in the GB group.
Quality of life and health utility showed improvement in the GB group, while remaining relatively constant in the MED participants. Although the cost of surgery was partially offset by savings on drugs, the overall difference (AU$8,861) favoured the MED group.
Although study was limited by its small sample size, the authors conclude that sustained weight loss of 10% is a powerful therapy for this group of individuals, delivering clinically meaningful improvements.
The article can be read in full here.
