To the Editor: Laparoscopic adjustable gastric banding (LAGB) is the most common bariatric surgery performed in Australia, and diabetic patients represent an important target population.1 In one of few trials in type 2 diabetes, 73% of 30 LAGB-treated obese patients reverted to normal glucose tolerance by 2 years, compared with 13% of 30 obese patients randomly assigned to treatment with changes to their lifestyle.2 These Australian data precipitated publicity implying that many people with type 2 diabetes were cured by LAGB.3,4 However, only recently diagnosed patients were recruited. The benefits of LAGB in those with diabetes of long duration (and usually with a substantial loss of pancreatic beta-cell function5) may not be as dramatic.
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- University of Western Australia, Fremantle, WA.
- 1. Colagiuri S. Diabesity: therapeutic options. Diabetes Obes Metab 2010; 12: 463-473.
- 2. Dixon JB, O’Brien PE, Playfair J, et al. Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial. JAMA 2008; 299: 316-323.
- 3. Lap band can “cure” obese of diabetes. Sydney Morning Herald 2007; 8 May. http://news.smh.com.au/national/lap-band-can-cure-obese-of-diabetes-20070508-blk.html (accessed Mar 2011).
- 4. McArthur G. Gastric band: cheap way to fight type 2 diabetes, obesity. Daily Telegraph 2009; 25 Feb. http://www.dailytelegraph.com.au/news/fight-fat-diabetes-on-cheap/story-0-1111118962467 (accessed Mar 2011).
- 5. Butler AE, Janson J, Bonner-Weir S, et al. Beta-cell deficit and increased beta-cell apoptosis in humans with type 2 diabetes. Diabetes 2003; 52: 102-110.