Adjustable Gastric Banding and Conventional Therapy for Type 2 Diabetes: A Randomized Controlled Trial

Dixon, John; O'Brien, Paul Edmond; Playfair, Julie; Chapman, Leon; Schachter, Linda M.; Skinner, Stewart; Proietto, Joseph; Bailey, Michael; Anderson, M. Robin

doi:10.1097/01.ogx.0000314848.71777.69

Cited by 111 publications

(190 citation statements)

References 0 publications

Supporting

Mentioning

178

Contrasting

Unclassified

Order By: Relevance

“…Surgical control of diabetes may thus be potentially obtained also in patients who do not meet current criteria for bariatric surgery (BMI >40 kg/m 2 or BMI >35 kg/m 2 with high-risk comorbid conditions). Recent reports corroborate this hypothesis showing that a variety of operations, including Roux-en-Y gastric bypass [3], duodenal-jejunal bypass [4] and gastric banding [5] can dramatically improve diabetes in patients with BMI <35 kg/m 2 . The physiological basis of the improvement in diabetes after surgery is still unclear; however, the dominant hypotheses involve changes in hormone signalling from the small bowel, which may influence insulin sensitivity, insulin secretion, or both.…”

Section: Introductionmentioning

confidence: 77%

The effect of bilio-pancreatic diversion on type 2 diabetes in patients with BMI <35 kg/m2

et al. 2009

View full text Add to dashboard Cite

Aims/hypothesis To aim of the study was to investigate the effect of bilio-pancreatic diversion (BPD) on type 2 diabetes in patients with BMI <35 kg/m 2 . Methods OGTTs were performed and anthropometric data were compared between five diabetes patients (BMI 27-33 kg/m 2 ) following BPD and seven diabetes patients after a low-energy diet. Insulin secretion was computed by C-peptide deconvolution. A euglycaemic-hyperinsulinaemic clamp was performed only in the BPD group and the M value measured. Results One month after BPD, fasting and 2 h post-OGTT glycaemia decreased from 15.22±3.22 to 6.22± 0.51 mmol/l (p=0.043), while insulin sensitivity increased significantly. No significant changes were observed in the low-energy diet group. Insulin secretion did not differ significantly after either intervention. Diabetes amelioration (change in HbA 1c level) was observed up to 18 months after BPD without pharmacological therapy. Conclusions/interpretation BPD can achieve adequate control of type 2 diabetes also in patients with BMI <35 kg/m 2 . The rapid postoperative remission of diabetes is primarily related to an improvement in insulin sensitivity.

show abstract

Section: Introductionmentioning

confidence: 77%

The effect of bilio-pancreatic diversion on type 2 diabetes in patients with BMI <35 kg/m2

et al. 2009

View full text Add to dashboard Cite

show abstract

“…28 Abdominal obesity and weight gain are documented as independent cardiovascular risk factors, due in part to their association with insulin resistance and sympathetic nervous activation. 29,30 Weight-loss studies with lifestyle modifications involving a low-calorie diet and exercise [31][32][33] as well as bariatric surgery 34,35 provide some evidence that intentional weight loss has long-term benefits on all cause mortality in overweight/obese adults. Therefore, weight loss is recommended as the first-line treatment for obesity.…”

Section: Discussionmentioning

confidence: 99%

Different mechanisms in weight loss-induced blood pressure reduction between a calorie-restricted diet and exercise

et al. 2011

View full text Add to dashboard Cite

The present study compared the effectiveness of a mild calorie-restricted diet (D) alone, exercise (EX) alone and a combination of D+EX on weight loss-induced blood pressure (BP) reduction over 24 weeks. We focussed especially on the relationship between sympathetic nervous activity, as indicated from measures of plasma norepinephrine (NE), and insulin resistance (homeostasis model of insulin resistance, HOMA-IR). The three groups each comprised 30 obese, hypertensive men. Body mass index (BMI), fat mass, waist-to-hip ratio, BP, plasma NE and HOMA-IR were measured every 2 weeks during the first 4 weeks and subsequently every 4 weeks for the next 20 weeks. All basal parameters were similar among the three groups. At 24 weeks, the combination group with D+EX comprised a significantly higher prevalence of normotensive subjects than the D alone or EX alone group (Po0.05). In the D alone group, plasma NE was decreased significantly at 2 weeks, reductions in BMI, fat mass and BP were observed at 8 weeks, and waist-to-hip ratios and HOMA-IR were decreased at 12 weeks. In comparison, in the EX alone group, significant reductions of fat mass and HOMA-IR were observed at 4 weeks. Plasma NE and HOMA-IR were reduced at 8 weeks while decreases in BP were detected at 12 weeks. In the D+EX group, significant reductions in plasma NE were observed at 2 weeks followed by significant decreases in BMI, fat mass, waist-to-hip ratio, BP levels and HOMA-IR at 4 weeks. The magnitudes of reductions of all parameters were greatest in the D+EX group. These results demonstrate that D+EX exerts a stronger ameliorative effect on weight loss, weight loss-induced BP reduction, normalization of BP, sympathetic activation and insulin resistance compared with D or EX alone. D and EX might, perhaps, exert different mechanisms on weight loss and weight loss-induced BP reduction; however, a combination of caloric restriction and exercise is preferred to control BP levels in obese hypertensive patients.

show abstract

“…The most convincing long-term data indicating that weight loss effectively lowers glycaemia have been generated in the follow-up of type 2 diabetic patients who have had bariatric surgery. In this setting, with a mean sustained weight loss of >20 kg, diabetes is virtually eliminated [42][43][44][45]. In addition to the beneficial effects of weight loss on glycaemia, weight loss and exercise improve coincident CVD risk factors, such as blood pressure and atherogenic lipid profiles, and ameliorate other consequences of obesity [41,46,47].…”

Section: Lifestyle Interventionsmentioning

confidence: 99%

Medical management of hyperglycaemia in type 2 diabetes mellitus: a consensus algorithm for the initiation and adjustment of therapy

et al. 2008

View full text Add to dashboard Cite

The consensus algorithm for the medical management of type 2 diabetes was published in August 2006 with the expectation that it would be updated, based on the availability of new interventions and new evidence to establish their clinical role. The authors continue to endorse the principles used to develop the algorithm and its major features. We are sensitive to the risks of changing the algorithm cavalierly or too frequently, without compelling new information. An update to the consensus algorithm published in January 2008 specifically addressed safety issues surrounding the thiazolidinediones. In this revision, we focus on the new classes of medications that now have more clinical data and experience.

show abstract

Adjustable Gastric Banding and Conventional Therapy for Type 2 Diabetes: A Randomized Controlled Trial

Cited by 111 publications

References 0 publications

The effect of bilio-pancreatic diversion on type 2 diabetes in patients with BMI <35 kg/m2

The effect of bilio-pancreatic diversion on type 2 diabetes in patients with BMI <35 kg/m2

Different mechanisms in weight loss-induced blood pressure reduction between a calorie-restricted diet and exercise

Medical management of hyperglycaemia in type 2 diabetes mellitus: a consensus algorithm for the initiation and adjustment of therapy

Contact Info

Product

Resources

About