written by Michael O’Leary
While the evidence showing that weight-loss surgery can halt type 2 diabetes in obese people grows, less is known about whether such a drastic intervention might also benefit people who are overweight, but not obese. (The difference between overweight and obese is a technical one. Obese refers to people with a body mass index of over 30. Overweight refers to people with a body mass index between 25 and 29.9. To calculate your own BMI, visit this link on the NIH website.)
In the first such study designed to make the case for bariatric surgery as treatment for type 2 diabetes in overweight people, Australian researchers compared outcomes in 25 people with a BMI of 25 to 30 treated with gastric band surgery and standard care with 25 similar people treated with standard care alone.
The researchers, led by Emeritus Professor Paul O’Brien and Dr John Wentworth from the Centre for Obesity Research and Education (CORE) at Manash University in Victoria, Australia, followed both groups for two years, and documented blood sugar control during that time. They published their findings in the April 8, 2014 The Lancet Diabetes & Endocrinology.
The gastric surgery consisted of minimally invasive laparoscopic surgery, sometimes called keyhole surgery due to the small incisions needed for the procedure, and placement of an adjustable band around the neck of the stomach to restrict food intake.
After two years, 12 (52 percent) of those in the gastric surgery group had their diabetes in remission, compared to two (8 percent) of those in the standard care group. In addition, the results showed a strong link between the amount of weight loss and the amount of diabetes control. The more weight loss the greater the reduction in diabetes.
One person in the surgery group needed a second surgery due to complications and four others needed adjustments to the gastric band that was too restrictive and made it difficult to eat.
It is a small study, but it is among the first to test such surgery in people who are not obese and normally don’t qualify for such surgery for weight-loss purposes. The researchers concluded that their study shows that weight-loss such as achieved with gastric banding should be given higher priority as a means of treating type 2 diabetes.
Nevertheless, It will require testing in many more people who are only overweight before weight-loss surgery wins FDA approval in the US for treatment of type 2 diabetes.