A type of weight-loss surgery called the LAP-BAND has been successful in putting type 2 diabetes in remission, according to researchers in Australia. Doctors from Monash University in Victoria found that the majority of people with type 2 diabetes who were treated with the stomach-reduction surgery achieved better blood-glucose control one year afterward. Results of the study were published in the February 2002 issue of Diabetes Care.

John B. Dixon, MBBS, and colleagues studied the effects of laparoscopic adjustable gastric banding (LAP-BAND) surgery on 50 people with morbid obesity and type 2 diabetes. All subjects were screened for diabetes, had a mean weight of about 302 pounds (meaning that half weighed less than 302 pounds and half weighed more), and had a Body Mass Index of 35 or higher.

The LAP-BAND procedure involves having an adjustable silicone band placed around the upper section of the stomach to create a small pouch.

"This limits food consumption and creates an earlier feeling of fullness," according to Inamed Corporation, the maker of the band. "The band is inflatable and connected to an access port placed close to the skin that allows surgeons to adjust the system to meet individual patient needs. The procedure is reversible and does not require cutting or stapling of the stomach."

One year after the operation, 64 percent (32) of the patients experienced remission of their type 2 diabetes, which was defined as having normal fasting blood glucose, A1C, fasting insulin and C-peptide levels, according to Diabetes Care. Average A1C levels were 7.8% before the operation and 6.2% one year after the operation. The subsequent weight loss caused significant improvements in cholesterol levels, hypertension, sleep, depression and quality of life.

Six percent of the patients experienced early complications (wound infections and need for respiratory support), and 30 percent of the patients experienced late complications (prolapse of the band, erosion of the band and leaking) that required follow-up treatment.

"Our experience with the LAP-BAND system shows that some patients with type 2 diabetes. truly benefit from its use. With obesity hitting epidemic proportions, this is a viable option that curtails severe obesity, which helps decrease the severity of risk of developing other co-existing conditions," said Dr. Dixon in the Inamed press release.

The LAP-BAND operation was recently approved for use in the United States. It promotes weight loss progressively over the first two to three years and plateaus at six years after the operation, the researchers state in the study.