Bariatric surgery achieves better short-term diabetes outcomes than medical therapy in obese people. It is not known if similar benefits occur in people who are overweight but not obese. We therefore randomized 51 overweight people (age 53.1±6.5 years) with recent-onset type 2 diabetes (duration 2.5±1.8 years) to receive either multidisciplinary medical management (n=26) or medical management combined with gastric band surgery (n=25). The primary outcome will be remission of diabetes at two years, defined as fasting and 2h glucose <7.0mmol/L and <11.1mmol/L without therapy.
In the surgical group, two patients refused surgery and one became ineligible (BMI<25kg/m2). All but one of the 22 operations were performed as day cases. After one year, gastric band surgery achieved better weight loss (11 v 3kg), a higher rate of diabetes remission (60 v 15%), reduced medication burden, improved glycemic control and better quality of life compared to medical care. In each group there were two serious adverse events requiring emergency hospitalization and one patient in the surgical group required elective revision surgery. Definitive two-year outcomes will be available in time for the ADS meeting.
These interim data suggest gastric band surgery in overweight people may achieve better longer-term diabetes outcomes than multidisciplinary medical care.