Adjustable Gastric Banding and Conventional Therapy for Type 2 Diabetes: A Randomized Controlled Trial
Abstract
Context Observational studies suggest that surgically induced loss of weight may be effective therapy for type 2 diabetes. Objective To determine if surgically induced weight loss results in better glycemic control and less need for diabetes medications than conventional approaches to weight loss and diabetes control. Design, setting, and participants Unblinded randomized controlled trial conducted from December 2002 through December 2006 at the University Obesity Research Center in Australia, with general community recruitment to established treatment programs. Participants were 60 obese patients (BMI >30 and Interventions Conventional diabetes therapy with a focus on weight loss by lifestyle change vs laparoscopic adjustable gastric banding with conventional diabetes care. Main outcome measures Remission of type 2 diabetes (fasting glucose level Results Of the 60 patients enrolled, 55 (92%) completed the 2-year follow-up. Remission of type 2 diabetes was achieved by 22 (73%) in the surgical group and 4 (13%) in the conventional-therapy group. Relative risk of remission for the surgical group was 5.5 (95% confidence interval, 2.2-14.0). Surgical and conventional-therapy groups lost a mean (SD) of 20.7% (8.6%) and 1.7% (5.2%) of weight, respectively, at 2 years (P Conclusions Participants randomized to surgical therapy were more likely to achieve remission of type 2 diabetes through greater weight loss. These results need to be confirmed in a larger, more diverse population a…
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A total of 8 articles were used across more than 1 component.
“A total of 8 articles were used across more than 1 component.141,142,144,148,156,159,168,169”
From 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults (2014) · cites this paper as [144]
A total of 10 studies (12 articles) met the inclusion criteria, were rated as good or fair quality, and are included in the summary table.
“A total of 10 studies (12 articles) met the inclusion criteria, were rated as good or fair quality, and are included in the summary table.141,142,144,148,151,155,156,159,161,168,169,172”
From 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults (2014) · cites this paper as [144]
Fifteen RCTs were identified comparing weight loss after bariatric surgery or medical therapy.
“Fifteen RCTs were identified comparing weight loss after bariatric surgery or medical therapy (5 reporting on RYGB, 3 on LAGB and the rest on mixed patient populations undergoing sleeve gastrectomy, BPD/DS, sleeve gastrectomy and/or banding) [21–35].”
In follow-up of type 2 diabetic patients who have had bariatric surgery, with a mean sustained weight loss of >20 kg, diabetes is virtually eliminated.
“In this setting, with a mean sustained weight loss of >20 kg, diabetes is virtually eliminated (42–45).”
From Medical Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy (2009) · cites this paper as [44]
In a recent randomized controlled trial comparing adjustable gastric banding to best available medical and lifestyle therapy in subjects with type 2 diabetes diagnosed less than 2 years before randomization and BMI 30-40 kg/m2, 73% of surgically treated patients achieved remission of diabetes compared with 13% of those treated medically.
“In this trial, 73% of surgically treated patients achieved “remission” of their diabetes, compared with 13% of those treated medically.”
From Standards of Medical Care in Diabetes—2009 (2009) · cites this paper as [97]
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“A total of 10 studies (12 articles) met the inclusion criteria, were rated as good or fair quality, and are included in the summary table (141,142,144,148,151,155,156,159,161,168, 169,172).”
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- Authors
- Dixon, J. B., O’Brien, P. E., Playfair, J., Chapman, L., Schachter, L. M., Skinner, S., Proietto, J., Bailey, M., & Anderson, M.
- Affiliations
- The Alfred Hospital (AU)
- The University of Melbourne (AU)
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2008-01-23
- Volume
- 299
- Issue
- 3
- Pages
- 316-23
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W1999414774
- Cited by
- 1,434
- References
- 45
- Citations by year
- 2026: 12 · 2025: 19 · 2024: 13 · 2023: 39 · 2022: 30 · 2021: 41 · 2020: 48 · 2019: 34 · 2018: 38 · 2017: 73 · 2016: 87 · 2015: 115 · 2014: 115 · 2013: 152 · 2012: 136
- FWCI
- 169.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 2 diabetes, laparoscopic adjustable gastric banding, bariatric surgery, diabetes remission, glycemic control, HbA1c, obesity, metabolic syndrome
- MeSH terms
- Adult, Blood Glucose, Diabetes Mellitus, Type 2, Female, Humans, Male, Middle Aged, Obesity, Laparoscopy, Remission Induction, Gastroplasty, Weight Loss, Exercise, Risk Reduction Behavior
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