Diabetes and the Lap Band: New Data

The APEX study is a 5 year study of the Lap Band. 2 years of that study have now been completed, and interim data is available. Many were excited to see that the two year results show that laparoscopic gastric banding is highly effective in treating obese patients with type 2 diabetes. The study found that two years following surgery, over 95% of the patients’ doctors reported improvement in patients’ glucose control, with 48.5% achieving diabetes remission and 47% showing improvement in hemoglobin A1c values. The interim report’s key finding is that the best opportunity for long‐lasting remission of type 2 diabetes calls for early surgical intervention, while beta cell function still remains.

The patients who experienced remission had greater weight loss, on average, at 2 years compared to the other patients, and had diabetes duration of just 4 years, compared to 6.7 years for the ‘improvement’ group and 9 years for the ‘no change’ group. The findings suggest that the main predictors of diabetes resolution following gastric banding are diabetes duration, amount of weight loss, and the severity of disease.

Currently, the American Diabetes Association estimates that an astonishing 25.8 million people in the United States have diabetes. With these numbers expected to increase over the next few decades, curing and treating diabetes is a top priority. While diet and weight loss are fundamental in the treatment of diabetes, lifestyle recommendations are often difficult to achieve and even more difficult to sustain. Weight loss surgery has been shown to be an effective method of achieving meaningful and long-lasting weight loss with improvements in diabetes.  In addition to the APEX study’s results, two recent studies published in the New England Journal of Medicine found that bariatric surgery is superior to medical therapy in treating obese patients with diabetes.

Dr. Bhoyrul is actively involved in the APEX study and is a co-author of the interim report.

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