Type 2 diabetes is a growing problem “ in England around 1.3 million people have diabetes and around 5% of total NHS resources are used for the care of people with diabetes.

Researchers from Leicester reviewed studies which measured the effects of different interventions - lifestyle, diabetes drug and anti-obesity drug - on people with impaired glucose tolerance*.

They found that lifestyle changes, e.g. switching to a healthier diet and increasing exercise to be at least as effective as taking prescription drugs. On average, lifestyle changes helped to reduce the risk of developing type 2 diabetes by around half. Lifestyle changes were also less likely to have adverse side-effects.

However, the researchers say that both lifestyle changes and prescription drug taking must be sustained in order to prevent the development of Type 2 diabetes.

The authors say that as global rates of Type 2 diabetes are likely to double by 2030, interventions to prevent the condition will have an important role to play in future health policies. The study findings have large implications for public health policy, however, the authors note that if lifestyle changes are to be truly effective more needs to be done to support people to adopt healthier lifestyles.

*People with impaired glucose tolerance have a high risk of developing type II diabetes

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The gastric banding procedure places an inflatable silicon ring around the upper portion of the stomach, creating a smaller stomach, which helps patients feel full and limits the amount of food they eat. The ring is connected to a port that is placed underneath the skin at the time of surgery. At regular monthly visits, the ring can be made tighter or looser by injecting saline into the port. This minimally invasive procedure is usually performed in under an hour. It is reversible, adjustable, and requires no cutting or rerouting of the gastrointestinal tract.

By comparison, during the gastric bypass procedure the surgeon divides the stomach and reshapes it into a small pouch. It is then connected directly to the middle portion of the small intestine, bypassing the rest of the stomach and the upper portion of the small intestine.

According to the study, twelve and eighteen months following their surgery, the average weight loss for each patient was about 50 percent of excess weight, a figure comparable to weight loss following a gastric bypass procedure. None of the patients regained any lost weight, which has occurred after gastric bypass procedures, said Dr. Nadler.

Complications were found to be significantly less severe with the band procedure as well. None of the gastric band patients in the study had complications that required readmission to the hospital. Two patients experienced slippage of the band, two patients developed hiatal hernias, and one patient had a wound infection. All of these conditions were treated by outpatient procedures. According to the study, a few patients also experienced mild hair loss and iron deficiency which were treated with nutritional counseling and vitamin supplementation.

med.nyu/