Banding May Reverse Diabetes in Obese

Diabetes patients who are obese may rapidly control their condition through gastric banding

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Weight loss surgery has been shown to keep diabetes at bay for those who are obese. One option, called gastric banding, may deliver fast results.

Recent studies have demonstrated the benefits of bariatric (weight loss) surgery. By consistently limiting calorie consumption, diabetes patients who are very overweight may be able to reverse their condition. Researchers have recently observed that a form of bariatric surgery called gastric banding may rapidly normalize glucose tolerance (the ability of the body to use blood sugar).

"Consider weight loss surgery to control diabetes if you're obese."

Katherine Samaras, PhD, professor of medicine, senior staff specialist in the Department of Endocrinology at St Vincent's Hospital and head of the Diabetes and Obesity Clinical Group at the Garvan Institute of Medical Research in Sydney, Australia, led research following 15 morbidly obese patients who had undergone gastric banding surgery.

To perform this procedure, a surgeon places a ring around the upper part of the stomach to create a small pouch to hold food. Those with a gastric band cannot eat as much and they eat more slowly.

The operation is usually done laparoscopically — meaning the doctor uses a tiny camera called a laparoscope — which is inserted in the belly. The surgeon makes one to five cuts in the abdomen to accommodate the camera and surgical instruments.

All study participants had diabetes for five years or more and a body mass index (BMI) greater than 40.

At two weeks, 70 percent of patients returned to normal glucose tolerance, and at 12 weeks, 80 percent had their blood sugar levels under control.

High blood sugar levels from diabetes may harm tissues and organs and lead to kidney failure and an increased risk of heart disease.

Fasting blood glucose (FBG) — a measure of glucose concentration in the blood after 8 to 12 hours of not eating — dropped from an average of 5.9 mmol/L (millimoles per liter) to 5.3 mmol/L at two weeks and 5.1 at 12 weeks. The average HbA1c (a measure of average blood glucose) level dropped from 52 mmol/mol to 45 at both two weeks and 12 weeks.

Dr. Samaras told the dailyRx News, “Obesity-related type 2 diabetes improved within two weeks of bariatric surgery, as the surgery forces people to restrict their energy intake rigorously and consistently. The weight reduction in this time was only very modest, thus we believe it was caloric restriction that mediated this effect, rather than weight loss.”

There is often some insulin production still present in people with type 2 diabetes. When food intake is cut substantially, this allows the demands of diet to be met by the insulin the body is capable of producing, according to Dr. Samaras.

The authors of the study also highlighted results showing that all patients had significantly reduced inflammation. The numbers of circulating pro-inflammatory immune cells were much reduced, mirroring the degree by which glucose levels fell.

"This suggests our metabolism and immune system are linked, possibly by our food intake,” said Dr. Samaras.

The study was published online in October in Diabetologia. The research was partially funded by a competitive, peer reviewed research grant from The Ladies Committee-Sister Bernice Award of the St. Vincent’s Clinic Foundation and by philanthropic grants from the GP Harris Foundation.

Review Date: 
October 22, 2013
Last Updated:
October 23, 2013