Gastrointestinal Surgery as a Treatment for Diabetes
- David E. Cummings, MD;
- David R. Flum, MD, MPH
- Author Affiliations: Division of Metabolism, Endocrinology and Nutrition, Department of Medicine (Dr Cummings) and Department of Surgery (Dr Flum), University of Washington, Seattle; and VA Puget Sound Health Care System, Seattle (Dr Cummings). Dr Flum is Contributing Editor, JAMA.
- Corresponding Author: David E. Cummings, MD, Department of Medicine, University of Washington, VA Puget Sound Health Care System, 1660 S Columbian Way, S-111-Endo, Seattle, WA 98108 (davidec{at}u.washington.edu).
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- ANASTOMOSIS, ROUX-EN-Y
- BARIATRIC SURGERY
- DIABETES MELLITUS
- DIABETES MELLITUS TYPE 02
- DIGESTIVE SYSTEM SURGICAL PROCEDURES
- GASTRIC BANDING
- WEIGHT LOSS
Approximately one-third of adults in the United States are obese,1 and largely because of this, at least as many have diabetes or prediabetes.2 With these escalating twin epidemics, the health care community has been challenged to develop novel treatment strategies.
In this issue of JAMA, Dixon and colleagues3 report a 2-year study in which patients with recently diagnosed type 2 diabetes and a body mass index (BMI) of 30 to 40 were randomly assigned to receive conventional medical/behavioral therapy (medical therapy and a focus on weight loss through lifestyle modification) or laparoscopic adjustable gastric banding (LAGB) plus conventional medical/behavioral therapy. The results were clear and striking. Complete remission of diabetes at 2 years was achieved in 73% of the patients in the LAGB group vs only 13% of those in the medical/behavioral therapy group, and the former experienced larger reductions in blood glucose levels, glycated hemoglobin …
