The most effective form of weight-loss surgery for morbid obesity – adjustable gastric banding - has the power to cure up to a third of those in the UK with early onset type 2 (acquired) diabetes; according to one of the world’s leading gastrointestinal surgeons and author of a new clinical study, Mr Paul Super, of Spire Parkway Hospital in Solihull, West Midlands.
Half of those diagnosed with type 2 diabetes are also obese and medical experts agree that significant weight loss is the most important aspect of diabetes management because of its ability to improve blood glucose control.
Studies confirm, however, that the success of gastric banding is dependent on the skills of the surgeon and patient follow-up procedures*, raising questions about the wisdom of people seeking surgery abroad in a bid to cut costs.
In studies co-authored by Mr Super, more than a third of those with diabetes and a BMI of 35+ lost 35% of their excess body weight as a result of gastric band surgery and went into remission from diabetes within 12 months of their operation.**
The results were even more compelling in leaner patients with a BMI of between 30 and 40 with a staggering 76% of patients becoming symptom free.***
A two-in-one cure for the UKs top health issues
Obesity and diabetes mellitus are two of the greatest health issues facing the UK today. A fifth of all men, a quarter of women and a quarter of pre-school children are now obese. A further 24 million adults are overweight.
More than 2.3 million people in Britain have diabetes with 500,000 more suspected of suffering from the condition without realising it. In 2004, the cost of diabetes management was reported to account for 5% of all UK healthcare expenditure and cost the NHS £1.3 billion per annum.
Substantial weight loss leads to remission
Mr Super who performs at least 10 laparoscopic adjustable gastric band operations a week from his clinic in the West Midlands, more than any other surgeon operating in the UK, has found that the greater the degree of weight-loss the greater the impact on diabetic symptoms.
His findings are supported by several other randomised clinical trials published in leading medical journals including The Journal of the American Medical Association (JAMA).
“We know now that weight control is the most significant factor in the management of type 2 diabetes in terms of its ability to reduce the incidence and mortality of this condition. The greater the degree of weight loss, the greater the control over blood glucose levels,” he said.
“Unfortunately the lifestyle and medical interventions typically used to treat diabetic patients only result in modest weight loss. This is because diabetics find it much harder to lose with than other people and, the heavier they are, the more difficult it is to control their condition because obesity triggers insulin resistance. As a result diabetic patients require increasing quantities of insulin to keep their blood sugar levels under control.
“In contrast, those who opt for gastric band surgery, tend to lose about 60% of their excess body weight within 18 months on average.
“The success of any weight-loss surgery is dependent not just of on the skills and experience of the surgical team. Patients MUST return for regular follow ups to enable us to adjust the band according to their needs, check for any signs of complications and ensure compliance with post-operative dietary regimens.
“This raises important questions about the wisdom of patients seeking gastric band surgery abroad as, studies confirm, that these people do not attend the frequent follow up visits necessary to ensure the safety and efficacy of this procedure” concluded Mr Super.
Adjustable gastric banding: the gold standard in weight-loss surgery
Gastric band surgery is the most popular form of weight-loss surgery and the safest, with up to 300,000 band placement performed to date worldwide and a mortality rate of just 0.05%.
An inflatable silicon band is placed around the upper part of the stomach to create a much smaller ‘pouch’ with a narrow opening to the rest of the stomach, significantly restricting the amount of food a patient can eat before they feel full. The band is adjusted over time to suit the patient’s progress or removed altogether if necessary.
*Jacques M Himpens: “Adjustable gastric banding: blessing or curse?” Annual of the Royal College of Surgeons England 2008; 90:2-6
**R, Kitchen M, Bridgewater S, Super P: “Metabolic outcomes of obese diabetic patients following laparoscopic gastric banding”. Obesity Surgery DO1 10.2007/s11695-008-9500-4
***Dixon John B et al: “Adjustable gastric banding and conventional therapy for type 2 diabetes”. JAMA, January 23, 2008: Vol 299