Study claims a cure for obese diabetics

Published 9:13 pm Tuesday, January 22, 2008

Stomach banding surgery for weight loss cured nearly three-quarters of obese patients with Type 2 diabetes — five times as many as could be cured by medications, dieting and lifestyle changes — Australian researchers reported today.

In the first head-to-head comparison of banding and conventional weight-loss techniques, obesity specialist John Dixon of Monash University in Melbourne and his colleagues found that patients receiving the band lost an average of 20.7 percent of their body weight, while those on a medically supervised diet lost 1.3 percent.

Among those who lost at least 10 percent of their body weight — a number that included only one patient on the medically supervised diet — 87 percent were able to stop taking all diabetes medications within a year. Among those on the diet who did not lose that much, only 12 percent were able to stop taking medications, and all of them had very mild cases of diabetes to begin with.

“It may be time to view bariatric operations … as interventions about which all obese patients with diabetes should be informed and given access,” Drs. David Cummings and David Flum of the University of Washington wrote in an editorial in the Journal of the American Medical Association.

Stomach band surgery is a procedure more common in Australia than in the United States, where gastric bypass surgery, or stomach stapling, dominates. Gastric bypass is even more effective against diabetes, achieving remission in a matter of days or a month, Cummings said.

In banding, an inflatable silicon band is placed around the stomach to limit its capacity. In a bypass, the stomach’s size is reduced by creating a small pouch at the top to which the intestines are reattached.

“We have traditionally considered diabetes to be a chronic, progressive disease,” said Cummings. “But these operations really do represent a realistic hope for curing most patients.”

The findings demonstrate that “Type 2 diabetes is a disease that should aggressively be treated with surgery and not merely controlled with medication,” said Dr. Mitchell Roslin of Lenox Hill Hospital in New York, who was not involved in the study. “The truth is that the treatment of diabetes requires a lifestyle modification and only surgery makes that practical for the majority of obese diabetics.”

The new study is limited by its small size — 60 patients were randomly assigned to receive either surgery or medically supervised weight loss. The patients also had been diagnosed with diabetes within two years of the surgery and did not suffer complications of diabetes, such as peripheral neuropathy.

Nearly 20 million Americans have Type 2 diabetes, which is typically associated with obesity.