Gastric banding as effective as metformin in slowing progression of prediabetes, type 2 diabetes

NIH-funded study also finds the surgery more effective for weight loss than medication.

What

People with prediabetes or new-onset type 2 diabetes who had gastric banding, a type of bariatric surgery for weight loss, had similar stabilization of their disease to those who took metformin alone, according to a study supported by the National Institutes of Health. These findings were published on October 3 in Diabetes Care(link is external), coinciding with a presentation during the European Association for the Study of Diabetes Annual Meeting in Berlin.

The Beta Cell Restoration through Fat Mitigation study, or BetaFat, enrolled 88 participants with mild to moderate obesity and either prediabetes or new-onset type 2 diabetes. Half of the participants were randomly assigned to receive a gastric banding procedure, involving placement of a band around the upper part of the stomach to slow digestion. The other participants received the drug metformin, the most common first-line medication for people with prediabetes and early type 2 diabetes. The BetaFat study was conducted at the University of Southern California, Los Angeles, in collaboration with Kaiser Permanente Southern California (NCT01763346).

After two years, people in the gastric banding group lost significantly more weight, an average of 23 pounds, compared to four pounds in the metformin group. The two treatment groups ended up with similar improvements in insulin sensitivity and relatively stable function of insulin-producing cells, with small improvements in blood glucose levels.

These results are part of the Restoring Insulin Secretion (RISE) study, a set of three clinical trials designed to find ways to reverse or slow the loss of insulin production and release in people at risk for type 2 diabetes or recently diagnosed with the disease so that they can stay healthier longer. While BetaFat compared results from surgical weight loss to medication, the two other RISE trials examine the effects of a variety of medications in youth and adults.

Who

Ellen Leschek, M.D., Program Director in the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases, the study’s lead funder, is available to comment on this study.

NIH support for RISE comes primarily through NIDDK grants U01DK94430, U01DK94431, U01DK94406, U01DK94438, and U01DK094467, with additional support from the National Center for Advancing Translational Sciences grant UL1TR1855. The Department of Veterans Affairs, Kaiser Permanente Southern California, and the American Diabetes Association also support the studies, with additional donations of supplies from Allergan Corporation, Apollo Endosurgery, Abbott Laboratories, and Novo Nordisk A/S.

The NIDDK, a component of the National Institutes of Health (NIH), conducts and supports research on diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition, and obesity; and kidney, urologic, and hematologic diseases. Spanning the full spectrum of medicine and afflicting people of all ages and ethnic groups, these diseases encompass some of the most common, severe, and disabling conditions affecting Americans. For more information about the NIDDK and its programs, see www.niddk.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

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