Weight-loss surgery reverses type 2 diabetes: Australian study

An Australian study suggests that surgery to reduce weight can cause remissions in Type 2 diabetes.

"Obese patients with Type 2 diabetes who underwent gastric banding [surgery] were five times more likely to have their diabetes go into long-term remission, compared with patients who engaged in conventional weight-loss therapies, such as a controlled calorie diet and exercise," Monash University in Melbourne, Australia, said in a release Tuesday.

After two years, the diabetes went into remission in 22 people (73 per cent) who had surgery but just four members (13 per cent) of the group who had conventional therapy, the abstract published in the Journal of the American Medical Association (JAMA) said. There were no serious complications in either group.

"It's the best therapy for diabetes that we have today, and it's very low risk," lead author Dr. John Dixon told the Associated Press.

But with only 55 people completing the two-year follow-up to the study, "the results need to be confirmed in a larger, more diverse population and have long-term efficacy assessed," the JAMA abstract said.

"We found that the amount of weight loss was a key determinant of effectiveness. Most of those losing 10 per cent of their total weight had remission of the diabetes. Few who lost less did so," Dixon said in a release.

The patients who had the surgery lost an average of 46 pounds, while those who didn't lost just three pounds.

Dixon and Prof. Paul O'Brien, both from the university's Centre for Obesity Research and Education, did the study. 

The 60 obese patients who began the study had a body mass index of between 30 and 40 (over 25 is overweight) and had been diabetic for less than two years.

By the end, the majority of the surgery patients no longer required diabetes drugs and their blood-sugar levels were normal.

Enthusiastic responses

"The results were clear and striking,"  Dr. David Cummings said in an editorial in the Jan. 23 edition of JAMA.

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

"This opens an entirely new way of thinking about diabetes," said Dr. Philip Schauer, who leads a Cleveland Clinic study that will look into surgery for obese people diabetics. He has done 4,000 operations for severe obesity and over 200 gastric band procedures. 

The gastric banding procedure sees a band placed around a small part of the patient's upper stomach, creating a pouch that fills up quickly with food. The stomach then sends the brain a message that it's full.

The food is released to the lower part of the stomach at a controlled rate, and the band can be adjusted without additional surgery to allow more or less food through. The surgery is done laparoscopically, through small incisions, rather than a large one.

Type 2 diabetes is very common and has been called an epidemic. More than two million Canadians have diabetes, most Type 2.