TY - JOUR
T1 - Long-term impact of weight loss for people with overweight but not obesity, and with type 2 diabetes
T2 - 10-year outcomes of a randomized trial of gastric band surgery
AU - Qi, Qi Yang Damien
AU - Playfair, Julie
AU - Brown, Wendy A.
AU - Burton, Paul
AU - O'Brien, Paul E.
AU - Wentworth, John M.
N1 - Funding Information:
The authors thank the study participants and their treating clinicians for helping us collate 10-year outcome data. We thank Alexandra Gorelik for statistical advice. This study was funded by the Department of Surgery, Monash University. The Department has received grants from Allergan and Applied Medical for research and educational support. The grants were not tied to any specific research projects and the grantors had no control over the protocol, analysis, and reporting of any studies. Allergan donated the lap-band prostheses used in this study. Open access publishing facilitated by The University of Melbourne, as part of the Wiley - The University of Melbourne agreement via the Council of Australian University Librarians.
Funding Information:
The authors thank the study participants and their treating clinicians for helping us collate 10‐year outcome data. We thank Alexandra Gorelik for statistical advice. This study was funded by the Department of Surgery, Monash University. The Department has received grants from Allergan and Applied Medical for research and educational support. The grants were not tied to any specific research projects and the grantors had no control over the protocol, analysis, and reporting of any studies. Allergan donated the lap‐band prostheses used in this study. Open access publishing facilitated by The University of Melbourne, as part of the Wiley ‐ The University of Melbourne agreement via the Council of Australian University Librarians.
Funding Information:
This study was sponsored by the Monash University Centre for Obesity Research and Education and approved by Monash University Human Research Ethics Committee. All participants provided written informed consent.
Publisher Copyright:
© 2023 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.
PY - 2023/6
Y1 - 2023/6
N2 - Aim: Randomized trials reporting 5-year outcomes have shown bariatric surgery to induce diabetes remission and improve cardiovascular risk. However, the longer-term effects of surgery are uncertain, with only one randomized trial reporting 10-year diabetes outcomes in people with obesity. We aimed to compare 10-year diabetes outcomes of people who are overweight but not obese, randomly assigned to receive either multidisciplinary diabetes care, or multidisciplinary diabetes care combined with gastric band (GB) surgery. Methods: Between 2009 and 2011, 51 adults were randomized. After 5 years, they were discharged to receive community care and reassessed after 10 years. The primary outcome was diabetes remission, defined as glycated haemoglobin (HbA1c) <6.5% (48 mmol/mol) without glucose-lowering medication. Results: Forty-one participants (20 medical and 21 GB) completed the 10-year assessment. The median (Q1, Q3) weight loss in the GB group was 9.8 (6.7, 16.3)% at 10 years compared with 5.6 (3.4, 7.6)% in the medical group (median difference 4.2%; p =.008). Diabetes remission occurred in five GB participants and no medical participants (relative risk 0.76, 95% CI: 0.55-0.93, p =.048). GB participants used fewer glucose-lowering medications at 10 years but HbA1c, fasting glucose, calculated cardiovascular risk, quality-of-life and incident diabetes complications did not differ significantly between the groups. Conclusion: When compared with medical care, GB surgery achieved greater weight loss and modestly increased the likelihood of diabetes remission. However, it did not improve HbA1c, cardiovascular risk or quality of life.
AB - Aim: Randomized trials reporting 5-year outcomes have shown bariatric surgery to induce diabetes remission and improve cardiovascular risk. However, the longer-term effects of surgery are uncertain, with only one randomized trial reporting 10-year diabetes outcomes in people with obesity. We aimed to compare 10-year diabetes outcomes of people who are overweight but not obese, randomly assigned to receive either multidisciplinary diabetes care, or multidisciplinary diabetes care combined with gastric band (GB) surgery. Methods: Between 2009 and 2011, 51 adults were randomized. After 5 years, they were discharged to receive community care and reassessed after 10 years. The primary outcome was diabetes remission, defined as glycated haemoglobin (HbA1c) <6.5% (48 mmol/mol) without glucose-lowering medication. Results: Forty-one participants (20 medical and 21 GB) completed the 10-year assessment. The median (Q1, Q3) weight loss in the GB group was 9.8 (6.7, 16.3)% at 10 years compared with 5.6 (3.4, 7.6)% in the medical group (median difference 4.2%; p =.008). Diabetes remission occurred in five GB participants and no medical participants (relative risk 0.76, 95% CI: 0.55-0.93, p =.048). GB participants used fewer glucose-lowering medications at 10 years but HbA1c, fasting glucose, calculated cardiovascular risk, quality-of-life and incident diabetes complications did not differ significantly between the groups. Conclusion: When compared with medical care, GB surgery achieved greater weight loss and modestly increased the likelihood of diabetes remission. However, it did not improve HbA1c, cardiovascular risk or quality of life.
KW - adjustable gastric band
KW - bariatric surgery
KW - diabetes remission
KW - overweight
KW - type 2 diabetes
KW - weight loss
UR - http://www.scopus.com/inward/record.url?scp=85148306292&partnerID=8YFLogxK
U2 - 10.1111/dom.14992
DO - 10.1111/dom.14992
M3 - Article
C2 - 36700392
AN - SCOPUS:85148306292
SN - 1462-8902
VL - 25
SP - 1464
EP - 1472
JO - Diabetes, Obesity and Metabolism
JF - Diabetes, Obesity and Metabolism
IS - 6
ER -
