Examining the Effectiveness of Lap Band Surgery in Resolving Type 2 Diabetes

Type 2 diabetes has become more prevalent in recent decades.  This is partly due to the rise of obesity, one of the major contributors to diabetes.  Gastric surgery for weight loss (bariatric surgery) has proven to be an excellent treatment for obesity.  Some bariatric surgery procedures also appear to help resolve diabetes.  Until now, researchers have only examined shorter term outcomes for laparoscopic adjustable gastric banding (lap band surgery).  Here, Dr. Christine Ren-Fielding and colleagues examined the longer-term outcomes of diabetic patients who had undergone lap band surgery. This groundbreaking study demonstrates encouraging results for people with both morbid obesity and type 2 diabetes.

Methods

Researchers examined patients who underwent lap band surgery at the NYU Langone Medical Center from January 2002 to June 2004.  Patients all met the American Diabetes Association criteria for type 2 diabetes.  None of the patients included had undergone gastric surgery for weight loss before.  For each patient, the researchers recorded age, gender, race, BMI, and date of diabetes diagnosis.  They also measured weight, fasting glucose levels, hemoglobin A1c (HbA1c), and medication levels.

From May 2008-2009, the research team collected follow-up data for as many patients as possible.  Researchers measured fasting plasma glucose levels (8 hour minimum fast) to gauge remission.  Glucose levels below 100 mg/dL and/or a HbA1c of less than or equal to 6.0 indicated remission.  No need for medication also indicated resolution of diabetes.  Beyond these criteria, reduced medication use and/or fasting glucose levels of 100-125mg/dL indicated improvement of diabetes.

Results

The research team examined outcomes for 631 patients who underwent lap band surgery at NYU Langone Medical Center.  Of those, 102 had diabetes and 95 met the criteria for inclusion in this study.  The average age before surgery was 49.3 and the average BMI was 46.3.  At the five year follow up, average BMI had decreased to 35.0 and the total excess weight loss was 48.3%.

23 of 58 patients met the criteria for resolution of diabetes, while 41 of 57 exhibited significant improvement.  The overall combined rate of remission and improvement and was 80% (which was 64 of 80 individuals) after bariatric surgery.

Conclusions of this Study

Previous research into lap band surgery as diabetes treatment focused on short term results, usually less than five-years after surgery. Dr. Christine Ren-Fielding’s new study indicates that this specific surgery has a significantly positive effect long term.

For an Evaluation by Dr. Christine Ren-Fielding

If you are considering bariatric surgery, please contact Dr. Christine Ren-Fielding to guide you through the process. Find out more information at the NYU Langone Weight Management Program.