Long-term impact of weight loss for people with overweight but not obesity, and with type 2 diabetes: ten-year outcomes of a randomised trial of gastric band surgery
- Author(s)
- Qi, QYD; Playfair, J; Brown, WA; Burton, P; O'Brien, PE; Wentworth, JM;
- Journal Title
- Diabetes Obesity and Metabolism
- Publication Type
- epub ahead of print
- Abstract
- INTRODUCTION: Randomised trials reporting five-year outcomes have shown bariatric surgery is more likely to induce diabetes remission and improve cardiovascular risk. However, the longer-term effects of surgery are uncertain, with only one randomised trial reporting ten-year diabetes outcomes in people with obesity. We aimed to compare ten-year diabetes outcomes of people who are overweight but not obese, randomly assigned to receive either multidisciplinary diabetes care (MDC), or MDC combined with gastric band (GB) surgery. METHODS: Between 2009 and 2011, 51 adults were randomised. After five years, they were discharged to receive community care and reassessed after ten years. The primary outcome was diabetes remission, defined as HbA1c<6.5% (48mmol/mol) without glucose-lowering medication. RESULTS: Forty-one participants (20 medical and 21 GB) completed the ten-year assessment. The median [Q1, Q3] weight loss in the GB group was 9.8 [6.7, 16.3] per cent at ten years compared to 5.6 [3.4, 7.6] per cent in the medical group (median difference 4.2 per cent; p=0.008). Diabetes remission occurred in five GB participants and no medical participants (relative risk 0.76, 95% CI 0.55 - 0.93, p = 0.048). GB participants used fewer glucose-lowering medications at ten 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 to 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. This article is protected by copyright. All rights reserved.
- Publisher
- Wiley
- Keywords
- Adjustable gastric band; bariatric surgery; diabetes remission; overweight; type 2 diabetes; weight loss
- Research Division(s)
- Population Health And Immunity
- PubMed ID
- 36700392
- Publisher's Version
- https://doi.org/10.1111/dom.14992
- Open Access at Publisher's Site
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Creation Date: 2023-03-17 11:09:14
Last Modified: 2023-06-13 01:05:20