Adjustable Gastric Banding and Conventional Therapy for Type 2 Diabetes

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

doi:10.1001/jama.299.3.316

Cited by 1,255 publications

(868 citation statements)

References 38 publications

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“…The U.S. government's Agency for Healthcare Research and Quality (AHRQ) and recent clinical studies report significant improvements in safety o Risk of death from bariatric surgery is about 0.1% 3 o Overall likelihood of major complications is about 4% 4 o Risks of living with morbid obesity outweigh the risks of bariatric surgery 5 Improvement or resolution of more than 30 obesity-related conditions, including Type 2 diabetes, heart disease, sleep apnea, hypertension and high cholesterol o Gastric bypass resolves Type 2 diabetes in nearly 90% of patients 6,7 o Gastric band surgery resolves Type 2 diabetes in 73% of patients 8 o Cuts risk of developing coronary heart disease in half 9 o Resolves obstructive sleep apnea in more than 85% of patients 10 Studies show bariatric surgery increases lifespan, as compared to those who do not have surgery o Patients may improve life expectancy by 89% 11 o Patients may reduce their risk of premature death by 30 -40% 12,13 o Risk of death from diabetes down 92%, from cancer down 60% and from coronary artery disease down 56% 13…”

Section: Impact Of Bariatric Surgery: Risks Vs Benefitsmentioning

confidence: 99%

Trimming the fat: obesity and hematopoietic cell transplantation

Weiss

Vogl

Berger

et al. 2012

Bone Marrow Transplant

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Section: Impact Of Bariatric Surgery: Risks Vs Benefitsmentioning

confidence: 99%

Trimming the fat: obesity and hematopoietic cell transplantation

Weiss

Vogl

Berger

et al. 2012

Bone Marrow Transplant

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“…This study compared LSG to gastric bypass (LSAGB) for the treatment of T2DM in Asian patients with BMI <35 kg/m 2 and was the first study to prove that gastric bypass (a duodenum exclusion procedure) had better efficacy on T2DM remission than LSG (non‐duodenum exclusion procedure). Following this landmark study, many RCT focusing on the comparison of metabolic surgery and medical treatment for the treatment of T2DM have been carried out and universally showed that metabolic surgery is more effective than medical treatment in glycemic control 91, 92, 93, 94, 95, 96, 97, 98, 99. Table 2 lists the results of RCT trials on surgical treatment versus medical treatment for T2DM.…”

Section: From Bariatric To Metabolic Surgerymentioning

confidence: 99%

Recent advancements in bariatric/metabolic surgery

Lee

Almalki

2017

Annals of Gastroent Surgery

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Obesity and type 2 diabetes mellitus (T2DM) are currently two pan‐endemic health problems worldwide and are associated with considerable increase in morbidity and mortality. Both diseases are closely related and very difficult to control by current medical treatment, including diet, drug therapy and behavioral modification. Bariatric surgery has proven successful in treating not just obesity but also in significantly decreasing overall obesity‐associated morbidities as well as improving quality of life in severely obese patients (body mass index [BMI] >35 kg/m2). A rapid increase in bariatric surgery started in the 2000s when the laparoscopic surgical technique was introduced into this field. Many new procedures had been developed and changed the face of modern bariatric surgery. Recently, bariatric surgery played as gastrointestinal metabolic surgery has been proposed as a new treatment modality for obesity‐related T2DM for patients with BMI >35 kg/m2. Strong evidence has demonstrated that bariatric/metabolic surgery is an effective and durable treatment for obese T2DM patients. Bariatric/metabolic surgery is now becoming an important surgical division. The present article examines and discusses recent advancements in bariatric/metabolic surgery and covers four major fields: (i) the rapid increase in numbers and better safety; (ii) new procedures with better outcomes; (iii) from bariatric to metabolic surgery; and (iv) understanding the mechanisms and personalized treatment.

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“…While approximately 11 % of people with a body mass index (BMI) [35 kg/m 2 [9, 41]-almost 18 million in the US alone-may be clinically eligible for BMS, only 1 % of those eligible have undergone surgery [42]. That gap between the eligible population and those who actually undergo BMS suggests barriers to access likely resulting in inferior care and higher overall costs.…”

Section: Treatment Of Obesity Comorbidities With Bariatric and Metabomentioning

confidence: 99%

Gap Between Evidence and Patient Access: Policy Implications for Bariatric and Metabolic Surgery in the Treatment of Obesity and its Complications

et al. 2015

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Despite consistently supportive evidence of clinical effectiveness and economic advantages compared with currently available non-surgical obesity treatments, patient access to bariatric and metabolic surgery (BMS) is impeded. To address this gap and better understand the relationship between value and access, the objectives of this study were twofold: (i) identify the multidimensional barriers to adoption of BMS created by clinical guidelines, public policies, and health technology assessments; and, most importantly, (ii) develop recommendations for stakeholders to improve patient access to BMS. Updated public policies focused on treatment and clinical guidelines that reflect the demonstrated advantages of BMS, patient education on safety and effectiveness, updated reimbursement policies, and additional data on long-term BMS effectiveness are needed to improve patient access.

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Adjustable Gastric Banding and Conventional Therapy for Type 2 Diabetes

Cited by 1,255 publications

References 38 publications

Trimming the fat: obesity and hematopoietic cell transplantation

Trimming the fat: obesity and hematopoietic cell transplantation

Recent advancements in bariatric/metabolic surgery

Gap Between Evidence and Patient Access: Policy Implications for Bariatric and Metabolic Surgery in the Treatment of Obesity and its Complications

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