Diabetes Remission After Lap-Band Surgery

Prof. Paul E O'Brien Centre for Obesity Research and Education Monash University Melbourne, AustraliaMedicalResearch.com Interview with:
Prof. Paul E O’Brien
Centre for Obesity Research and Education
Monash University
Melbourne, Australia

 

MedicalResearch.com: What are the main findings of the study?

Prof. O’Brien: Using a randomised trial format we compared the diabetes status at two years after a program of multidisciplinary diabetes care (MDC) alone or with the addition of a Lap-Band procedure in 50 people who were overweight (BMI 25-30) and with diabetes. 52% of the Lap-Band group had remission of their diabetes as measured by glucose tolerance testing compared to 8% in the multidisciplinary diabetes care group. The Lap-Band procedures were performed as outpatients with a 2-3 hr length of stay. There were no perioperative adverse events. The surgical group had lost a mean of 11.5kg in weight. The incremental cost effectiveness ratio (ICER) for remission of diabetes was AUD $20,700.

MedicalResearch.com: Were any of the findings unexpected?

Prof. O’Brien: As expected, there was a clear relationship between the amount of weight lost and resolution of diabetes in both groups but several of the Lap-Band group who had good weight loss were nevertheless resistant to resolution of diabetes. We would like to understand better why they were resistant.

MedicalResearch.com: What should clinicians and patients take away from your report?

Prof. O’Brien: Diabetes is a serious chronic disease and early and continued optimal  management of dysglycaemia should be an absolute priority. The study opens a safe, minimally invasive and cost-effective pathway for this to happen.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Prof. O’Brien: The durability of effect is the most important next step and we intend to continue following these patients to 5 yr at least. We have studied pancreatic beta cell function at the start and at 2 yr and hope this will give us a predictor of who will respond to weight loss treatment.

Citation:

Multidisciplinary diabetes care with and without bariatric surgery in overweight people: a randomised controlled trial

John M Wentworth PhD,Julie Playfair BHSc,Cheryl Laurie BHSc,Matthew E Ritchie PhD,Wendy A Brown PhD,Paul Burton PhD,Jonathan E Shaw PhD,Prof Paul E O’Brien MD
The Lancet Diabetes & Endocrinology – 8 April 2014
DOI: 10.1016/S2213-8587(14)70066-X

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