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Lap-Band as a Treatment Method for Diabetes

written by: AngelicaMD • edited by: lrohner • updated: 10/31/2010

The connection between lap band and diabetes is clear. Surgically induced weight loss by reducing the size of the stomach is now an accepted method of treating obesity and its complications. Studies show that gastric lap-band results in remission of diabetes type II due to significant weight loss.

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    What is a Lap-Band?

    Laparoscopic adjustable gastric band or more commonly known as lap-band is an inflatable device that is inserted by laparoscopic surgery to decrease the size of the stomach. It is a type of bariatric surgery which is a procedure performed on the obese to induce weight loss. In contrast to gastric bypass surgery, another popular type of bariatric surgery, the lap-band is less invasive and does not consist of cutting or stapling any part of the stomach or intestine.

    Lap-bands are recommended for the following people:

    • Obese, with a body mass index (BMI) of 35-40
    • Adults aged 16-55 years
    • Those whose weight has not been controlled effectively by diet or weight loss drugs for more than one year
    • Those who have been obese for 5 or more years
    • Those who understand the benefits and risks of the procedure and are willing to comply with dietary restrictions that go with the post-operative management for a long time

    It is not recommended for those who are severely ill, mentally incompetent or uncooperative with lifestyle changes, alcoholics, drug dependents and those afflicted with diseases like hypothyroidism, heart disease, gastric ulcers and others.

    In this procedure an inflatable band is inserted through a very small incision on the abdomen and applied on top of the stomach to create a small pouch that can hold approximately 1/2-cup of food. The band is inflated with a small amount of salt solution to decrease the opening to the rest of the organ, thus regulating passage of food. This makes the individual have a feeling of fullness with a small amount of food, delays hunger and makes him eat fewer portions at a time.

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    Benefits of Lap-Band for Type II Diabetics

    The connection between lap band for diabetes treatment and prevention is clear. It stems from the fact that it causes significant reduction of weight which is the most important factor in the causation of type II diabetes.

    Because of the resulting weight loss over time (approximately 1 to 2 pounds per week) an obese individual suffering from diabetes type II is more likely to decrease blood sugar levels without the use of medications compared to patients who are treated with conventional diet and drugs. This was observed in a clinical study of 60 patients who were followed up over 2 years. The results showed that 73% of those who underwent lap-band surgery experienced remission from the disease which was related to significant weight loss.

    Hospital stay is short and recovery is quick. The band may be removed, adjusted or re-inflated anytime. Since the procedure is less invasive and less traumatic than other types of bariatric surgeries, it carries with it less complications and risk of death.

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    Potential Risks and Complications of Lap-Band

    The most common complaint in people who undergo lap-band insertion is regurgitation of swallowed food from the small stomach pouch. While an individual is supposed to eat less and at longer intervals, one may eat too much or too fast and experience this discomfort. Furthermore, when one chews fast and swallows incompletely chewed food the big particles may block the small opening of the stomach and cause regurgitation or vomiting.

    Less common complications related to the surgery include malpositioning, slippage or misplacement of the band which may make the surgery ineffective and post-operatively, internal bleeding and infection.

    Other complications related to the patient himself include:

    • Nausea and vomiting
    • Diarrhea or constipation
    • Gastric ulcers or gastritis
    • Difficulty in swallowing
    • Abdominal pain, fever, chest pain, infection
    • Hypoglycemia due to insulin hypersecretion
    • Vitamin and mineral deficiencies

    Complications and death rates from this procedure have been reduced over time with increased experience. Gastric lap-band surgery is now considered to be the “best available” medical and lifestyle therapy for obese diabetics. Its long term cost-effectiveness however, has to be proven with more research.

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    References

    JAMA, “Adjustable Gastric Banding and Conventional Therapy for Type 2 Diabetes” accessed 10/26/10

    http://jama.ama-assn.org/cgi/content/abstract/299/3/316

    Wikipedia, “Adjustable gastric band” accessed 10/26/10

    http://en.wikipedia.org/wiki/Lap_band_surgery

    American Diabetes Association, “Standards of Medical Care in Diabetes -2010”, accessed 10/21/10

    http://care.diabetesjournals.org/content/33/Supplement_1/S11.full.pdf+html